Catastrophic Candida prosthetic valve endocarditis and COVID-19 comorbidity: A rare case

Document Type : Case report

Authors

1 Antimicrobial Resistance Research Center, Communicable Diseases Institute, and Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran

2 Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

3 Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran

4 Department of Cardiology, Mazandaran University of Medical Sciences, Sari, Iran

5 Invasive Fungi Research Center(IFRC),Communicable Diseases Institute, and Department of Medical Mycology, Mazandaran University of Medical Sciences, Sari, Iran.

10.18502/cmm.7.2.7157

Abstract

Background and Purpose: COVID-19 and Candida prostatic valve endocarditis present various clinical manifestation may overlap, so discriminating between them extremely difficult.
Case report: We describe a 66-year-old man with a past medical history of mitral and aortic valves replacement one year before COVID-19 co-infection. He admitted with seven days fever, shortness of breath, cough, seizures, lethargy, headache, and oxygen saturation 85%. Transesophageal echocardiography revealed multiple large-sized, highly mobile masses on both sides of the mechanical mitral valve highly suggestive of vegetation. Chest computed tomography scanning showed simulating scattered Covid-19 peripheral ground-glass opacities confirmed by reverse-transcription polymerase chain reaction. The set of blood cultures yielded yeast colonies that identified as Candida tropicalis. The patient died of septic shock shortly after receiving antifungal therapy.
Conclusion: This case emphasizes the importance of early diagnosis and implements antifungal treatment, particularly in patients with prosthetic cardiac valves, to reduce their unfavorable outcomes in COVID-19 patients.

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