Document Detail


Candida kefyr endocarditis in a patient with hypertrophic obstructive cardiomyopathy.
MedLine Citation:
PMID:  20087170     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report an uncommon but emerging fungal pathogen, Candida kefyr, as a causative agent of infective endocarditis in a patient with a known history of hypertrophic obstructive cardiomyopathy. A 74-year-old woman with diabetes type II, hypertrophic obstructive cardiomyopathy, presented with gross hematuria and abdominal pain. Computed tomography scan revealed a hemorrhagic mass in the superior pole of the right kidney, with a thrombus extending from the ureter to the bladder. She underwent cryotherapy of the renal mass, together with retrograde ureteral stent placement, developed hypotension and respiratory distress, spiked high-grade fever, and had a new pansystolic murmur over the mitral and aortic areas. Urine and blood culture grew C. kefyr. Transthoracic echocardiogram revealed large mitral valve vegetation with moderate regurgitation. Micafungin was started, patient responded, and fungemia cleared. Repeat echocardiogram showed small vegetation, preserved leaflet mobility and mild regurgitation. Patient received 10 days of micafungin, followed by 6 weeks of fluconazole.
Authors:
Teena Chopra; Ashish Bhargava; Sachin Kumar; Anita Chopra; Sorabh Dhar; Luis Afonso; Jack D Sobel
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  339     ISSN:  1538-2990     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-11     Completed Date:  2010-03-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  188-9     Citation Subset:  AIM; IM    
Affiliation:
Wayne State University, Detroit, Michigan 48201, USA. teenadmc@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Antifungal Agents / therapeutic use
Candidiasis / complications*
Cardiomyopathy, Hypertrophic / complications*
Echinocandins / therapeutic use
Endocarditis / complications*,  microbiology*
Female
Fluconazole / therapeutic use
Humans
Kidney Neoplasms / complications,  surgery
Lipopeptides / therapeutic use
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Echinocandins; 0/Lipopeptides; 0/micafungin; 86386-73-4/Fluconazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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