Cryptococcus neoformans endocarditis in an immunocompetentpatient a case report

McGuire, Colin N.; Walter, Dylan J.

doi:10.1186/s12872-022-02997-9

BMC Cardiovascular Disorders

Table 1 Literature review of published cases with Cryptococcous neoformans endocarditis

From: Cryptococcus neoformans endocarditis in an immunocompetentpatient a case report

Reference	Year	Age, sex	Symptoms	Comorbidities	ISx	Serum testing	Diagnostic imaging	Infectious focus	Valve location	Treatment	Complication	Survival
Harford et al. [14]	1974	51, M	Fever	Pancytopenia	+	Blood Cx	Autopsy	Prosthetic	AV	Amphotericin B	Pneumonia, Abdominal wall abscess	0
Boden et al. [16]	1979	56, M	Weakness, Delirium	Hematologic malignancy	+	Cryptococcal antigen	TTE	Native	MV	Amphotericin B	Meningitis, MI	0
Blanc et al. [17]	1983	27, M	Fever, Seizures	CKD, AR	+	Blood Cx	Surgery	Prosthetic	AV	Amphotericin B, Flucytosine	Meningitis, Cardiac abscess	+
Banerjee et al. [18]	1996	12, M	Fever	Rheumatic heart disease	0	Blood Cx	TTE	Prosthetic	MV	Amphotericin B, Fluconazole	Cerebral abscess	+
Banerjee et al. [18]	2020	57, F	Headache, Fatigue, Syncope	Cardiomyopathy, AICD Implantation, Vasculitis	+	Blood Cx	TTE, TEE	AICD Lead	0	Amphotericin B, Flucytosine, Fluconazole 6 weeks	Meningitis	+
Jone et al. [12]	1997	48, M	Fever, Surgical dehiscence	Rheumatic heart disease	0	Thrombus Cx	None	Prosthetic	0	Amphotericin B	Cerebral infarction	0
Alhaji et al. [5]	2011	41, M	Fever, Weight loss, Cough, Dizziness	CKD, Bicuspid aortic valve	0	Blood Cx	TEE	Prosthetic	AV	Amphotericin B	0	+
Sajjadi et al. [6]	2018	26, M	Shortness of breath	IV-drug use	0	Blood Cx	TTE	Native	AV	Amphotericin B, Fluconazole	0	+
Child et al. [15]	2018	46, M	Hemiplegia	Leukemia	+	Vegetation Cx	TTE	Native	MV	Voriconazole, Capsofungin	Cerebral infarction	+
Nakajima et al. [4]	2019	72, M	Fever, Respiratory failure	Diabetes, Interstitial pneumonia, AICD	+	Blood Cx	TEE	AICD Lead	0	Micafungin, Fluconazole, Amphotericin B	Meningitis	0
Kowatari et al. [19]	2020	50, M	Fever, chest pain, shortness of breath	CVA, Hepatitis B	0	Blood Cx	TTE	Native	AV	Surgery, Cefminox, Amphotericin B, Fluconazole 10 weeks	0	+
Present case	2021	65, F	Shock, Bradycardia, Delirium, Respiratory failure	COVID-19 pneumonia, CKD, COPD, IV-drug use	0	Blood Cx	TTE	Native	AV	Amphotericin B, Flucytosine, Fluconazole	Cerebral infarction, Meningitis, Cardiogenic shock	0

Case Summaries to Date: Summary table of all case reports involving Cryptococcus neoformans endocarditis. 12 documented cases in literature from 1957 to 2021. Ages range 4 years to 65 years old. 10 males, 2 females. Common symptoms at presentation include fever, pulmonary complaints, and delirium. The most common comorbidities include chronic kidney disease, immunosuppression, valvular disease and intravenous drug use. Immunosuppressed patients are more often infected. Non-suppressed patients frequently had prosthetic heart valves. Only the aortic and mitral valves have been implicated. 3 cases of immune-competent patients without a prosthetic valve are known. Treatment has included amphotericin B. in every case. Medical complications commonly include meningitis and cerebral infarction. Death occurred in 5 out of 12 cases
AICD automated implanted cardiac defibrillator, AR aortic regurgitation, AV aortic valve, CKD chronic kidney disease, COPD chronic obstructive pulmonary disease, CVA cerebral vascular accident, F female, ISx immunosuppression, IV: intravenous, M male, MI myocardial infarction, MV mitral valve, TEE transesophageal echocardiogram, TTE transthoracic echocardiogram, + present/yest; 0: absent/no.

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ISSN: 1471-2261

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