B37.6

Clinical Causes: Prolonged use of intravenous catheters Immunosuppressive therapy or immunodeficiency conditions Prolonged broad-spectrum antibiotic use that disrupts normal flora Intravenous drug use with contaminated needles Pre-existing heart valve disease or prosthetic heart valves Hospitalization, especially in intensive care units (ICUs) Neutropenia or other blood disorders

Key Symptoms: Fever that persists or fluctuates Chills and sweating Fatigue and weakness Shortness of breath or difficulty breathing New or changed heart murmurs Swelling in legs, abdomen, or other parts of the body Unintentional weight loss Symptomatic embolic events, such as stroke or skin lesions Persistent cough or chest discomfort

Diagnosis Path: The diagnosis of candidal endocarditis involves a combination of clinical assessment and laboratory investigations. Blood cultures are crucial, as they can identify Candida presence in the bloodstream. Imaging techniques such as echocardiography (particularly transesophageal echocardiography) help visualize the heart valves and detect vegetations or growths characteristic of the infection. Additional tests may include biomarker analysis and histopathological examination if surgical tissue samples are available. Due to its rarity and nonspecific symptoms, maintaining a high index of suspicion is vital in high-risk groups.

Treatment Protocols: Managing candidal endocarditis typically involves a combination of antifungal therapy and surgical intervention. Antifungal medications such as amphotericin B, flucytosine, or azole antifungals are administered based on susceptibility testing and clinical response. The therapy duration often extends over several weeks. In many cases, especially when structural damage or large vegetations are present, surgical removal of infected valves or repair of cardiac tissue may be necessary. Supportive care, including management of complications like embolic events, is also an integral part of treatment. Prevention strategies focus on minimizing risk factors, such as strict aseptic techniques during invasive procedures, proper management of underlying immunosuppression, and vigilant monitoring of high-risk patients.