Fungal Endocarditis in neonates: Case report and review of 79 cases (1983 to 2024)

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale Pub Date : 2025-03-07 DOI:10.1016/j.mycmed.2025.101542

Natália Daiane Garoni Martins , Beatriz dos Santos Bezerra , Cinthya Alves Esteves , Luana Rossato

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引用次数: 0

Abstract

Purpose

Fungal endocarditis in neonates poses a significant clinical challenge, with limited comprehensive data available. The aim of this study was describe a case report and further characterize demographic and clinical aspects of fungal endocarditis in neonates.

Methods

We present, a case report of a very low birth weight infant with fungal endocarditis. We also conducted a thorough analysis of 79 documented clinical cases, exploring demographics, clinical characteristics, treatment strategies, and outcomes.

Results

The temporal distribution revealed varied trends over the years. The United States had the highest case count, followed by India, Turkey, and Israel. Prematurity was predominant, with extremely low birth weight neonates being most affected. Congenital malformations were present in 10.2 % of cases. Surgical interventions, particularly for vegetative mass removal, were common. Candida albicans was the primary pathogen, followed by Candida parapsilosis. Catheter use was strongly associated with the majority of cases. The overall mortality rate was 38 %. Higher mortality was observed in neonates receiving monotherapy compared to those on combination therapy. Mortality was also significantly higher in neonates with prior bacteremia or fungemia and in those receiving antibiotic therapy without confirmed bacteremia. Conversely, postoperative mortality associated with surgery was 36.4 %, slightly lower than the overall mortality rate, suggesting that surgery may not represent an increased risk.

Conclusion

Our study provides comprehensive insights into fungal endocarditis in neonates, highlighting the need for tailored management strategies to improve outcomes.

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新生儿真菌性心内膜炎79例报告（1983 ~ 2024年）

目的新生儿真菌性心内膜炎是一项重大的临床挑战，但综合数据有限。本研究的目的是描述一个病例报告，并进一步表征新生儿真菌性心内膜炎的人口学和临床方面。方法报告1例极低出生体重儿并发真菌性心内膜炎。我们还对79例临床病例进行了全面分析，探讨了人口统计学、临床特征、治疗策略和结果。结果时间分布呈现出不同的变化趋势。美国的病例数最多，其次是印度、土耳其和以色列。早产是主要的，极低出生体重的新生儿是最受影响的。10.2%的病例存在先天性畸形。手术干预，特别是植物性肿块切除是常见的。白色念珠菌是主要病原菌，其次是假丝菌。导管的使用与大多数病例密切相关。总死亡率为38%。与联合治疗相比，接受单一治疗的新生儿死亡率更高。既往有菌血症或真菌血症以及接受抗生素治疗但未确诊菌血症的新生儿死亡率也明显较高。相反，与手术相关的术后死亡率为36.4%，略低于总体死亡率，表明手术可能不代表风险增加。结论：我们的研究为新生儿真菌性心内膜炎提供了全面的见解，强调了定制管理策略以改善预后的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal de mycologie medicale 医学-真菌学

CiteScore

5.10

自引率

2.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal de Mycologie Medicale / Journal of Medical Mycology (JMM) publishes in English works dealing with human and animal mycology. The subjects treated are focused in particular on clinical, diagnostic, epidemiological, immunological, medical, pathological, preventive or therapeutic aspects of mycoses. Also covered are basic aspects linked primarily with morphology (electronic and photonic microscopy), physiology, biochemistry, cellular and molecular biology, immunochemistry, genetics, taxonomy or phylogeny of pathogenic or opportunistic fungi and actinomycetes in humans or animals. Studies of natural products showing inhibitory activity against pathogenic fungi cannot be considered without chemical characterization and identification of the compounds responsible for the inhibitory activity. JMM publishes (guest) editorials, original articles, reviews (and minireviews), case reports, technical notes, letters to the editor and information. Only clinical cases with real originality (new species, new clinical present action, new geographical localization, etc.), and fully documented (identification methods, results, etc.), will be considered. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.