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Candida endocarditis associated with cardiac rhythm management devices: review with current treatment guidelines
Author(s) -
Halawa Ahmad,
Henry Philip D.,
Sarubbi Felix A.
Publication year - 2011
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/j.1439-0507.2010.01866.x
Subject(s) - endocarditis , medicine , candida albicans , antifungal , implantable cardioverter defibrillator , intensive care medicine , dermatology , microbiology and biotechnology , biology
Summary Coincident with an increased use of cardiac rhythm management devices (CRMD) has been an increase in the number of pacemaker and cardioverter‐defibrillator infections. CRMD endocarditis accounts for about 10% of all device‐related infections, and cardiac infection caused by Candida sp. is a rare event. To date, only sporadic reports of this unusual and life‐threatening event have been reported. By describing a case of CRMD‐related Candida endocarditis and conducting a literature review, we provide a detailed characterisation of this unusual clinical entity with an emphasis on diagnosis, management and treatment. A case of CRMD‐related Candida endocarditis is presented and a computer search for confirmed cases of CRMD‐ Candida endocarditis was conducted. Current recommendations for management and treatment were documented. From 1969 to 2009, 15 patients with CRMD‐ Candida endocarditis (12 pacemaker and three implanted cardioverter‐defibrillator) were documented. All were males, non‐albicans Candida sp. were frequently recovered, a major fungal embolus occurred in 27% of patients and two of 10 patients who received defined antifungal therapy and device explantation expired. CRMD Candida endocarditis is a rare and serious clinical event; isolates can include Candida albicans and other Candida sp., and treatment involves both targeted antifungal therapy and device removal.