Successful medical management of fungal infective endocarditis post VSD closure

Abstract

Fungal infective endocarditis (IE) is uncommon in postoperative cardiac surgical patients. The fungal IE accounts for 1.3%-6.8% of all IE cases and is considered the most severe form with a mortality rate as high as 45%-50%. There are various predisposing factors for fungal IE which include congenital heart defects, cardiac interventions like pacemaker insertion, degenerative valvular heart diseases, long-term use of broad-spectrum antimicrobial therapy, and long-term use of central venous. Mortality can reach up to 100% without specific treatment. Definitive therapy necessitates surgical debridement of vegetations/mass/abscess followed by long-term treatment with antifungal agents in patients who have symptoms of heart failure despite optimum medical management. We, hereby, report a case of fungal IE which occurred after the closure of a ventricular septal defect and was treated successfully with liposomal amphotericin B.