Refractory Candida orthopsilosis endocarditis in a hemodialysis patient: The role of species-level identification and surgical source control.
Maria Eduarda Pierre, Alessandro Pascon Filho, José Alberto Kfouri da Silva Trazzi et al.
✦ AI-curated · Sources linked
Case in brief
A 60-year-old woman on hemodialysis with diabetes and chronic kidney disease developed catheter-related fungemia that progressed to infective endocarditis caused by Candida orthopsilosis. Identification was achieved using MALDI-TOF mass spectrometry. Despite antifungal treatment, she experienced persistent positive blood cultures and septic pulmonary embolism. Surgical valve replacement led to microbiological clearance within 24 hours, followed by a six-week course of fluconazole.
Diagnostic / clinical pearl
MALDI-TOF mass spectrometry is crucial for accurate species-level identification of Candida in cases of suspected endocarditis, particularly within the Candida parapsilosis complex.
Why it matters
This case highlights the importance of timely surgical intervention and species-specific antifungal therapy in managing severe Candida endocarditis, which can lead to significant systemic complications.