Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Feb 24;17(2):e79550.
doi: 10.7759/cureus.79550. eCollection 2025 Feb.

Prosthetic Aortic Valve Endocarditis Due to Candida glabrata Successfully Treated With Intravenous Micafungin Followed by Oral Fluconazole Without Surgery: A Case Report and Literature Review

Muhammad Waqar Elahi  1 , Eric Huang  2 , Vikash Kumar  3 , Mona Ghias  3 , David Shi  2
Affiliations
Case Reports

Prosthetic Aortic Valve Endocarditis Due to Candida glabrata Successfully Treated With Intravenous Micafungin Followed by Oral Fluconazole Without Surgery: A Case Report and Literature Review

Muhammad Waqar Elahi et al. Cureus. .

Abstract

Fungal endocarditis (FE) is an uncommon and life-threatening disease with unacceptably high mortality rates. Only a handful of cases of FE caused by Candida glabrata have been reported in the literature so far. We present a case of C. glabrata prosthetic valve endocarditis (PVE) in a 59-year-old woman with a history of prosthetic aortic valve who was admitted after outpatient blood cultures came positive for yeast (later identified as C. glabrata). A trans-esophageal echocardiogram showed vegetation on the prosthetic aortic valve. The patient was successfully treated with intravenous (IV) micafungin as she was deemed unfit for valve replacement surgery due to multiple high-risk comorbidities. The patient was treated with six weeks of IV micafungin followed by oral fluconazole for lifelong suppression, and she remained well at follow-up six months later. In this report, we review the latest literature on FE and discuss the role of antifungal therapy in its management.

Keywords: bactetermia; candida endocarditis; endocarditis; fungemia; prosthetic aortic valves.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. A transesophageal echocardiogram image showing an echo density measuring 1.1 x 0.2 cm (yellow circle) on the prosthetic aortic valve, consistent with a vegetation.
Figure 2
Figure 2. Another transesophageal echocardiogram (TEE) imaging confirming the presence and location of vegetation on the prosthetic aortic valve (yellow circle).
See this image and copyright information in PMC

References

    1. Native aortic valve fungal endocarditis. Chaudhary SC, Sawlani KK, Arora R, Kumar V. BMJ Case Rep. 2013;2013 - PMC - PubMed
    1. Fungal endocarditis, 1995-2000. Pierrotti LC, Baddour LM. Chest. 2002;122:302–310. - PubMed
    1. Incidence and outcome of documented fungal endocarditis. Badiee P, Amirghofran AA, Ghazi Nour M, Shafa M, Nemati MH. Int Cardiovasc Res J. 2014;8:152–155. - PMC - PubMed
    1. Fungal endocarditis: pathophysiology, epidemiology, clinical presentation, diagnosis, and management. Thompson GR 3rd, Jenks JD, Baddley JW, et al. Clin Microbiol Rev. 2023;36:0. - PMC - PubMed
    1. 2015 ESC Guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM) Habib G, Lancellotti P, Antunes MJ, et al. Eur Heart J. 2015;36:3075–3128. - PubMed

Publication types

LinkOut - more resources