Clinical and Demographic Properties of Candida Endocarditis in a Tertiary Heart Center

Background: Candida is a rare but important cause of infective endocarditis. The study aimed to describe clinical data on patients with Candida endocarditis treated in cardiology and cardiovascular surgery hospital between 2012-2023. Methods: Patients diagnosed with infective endocarditis were reviewed retrospectively. Demographic information, medical histories, clinical data, and information on outcome and treatment were presented. Results: Four (29%) of 14 patients were female, and 10 (71%) were male. The mean age was 49.7 (+/- 8.82) years. The mean hospital stay was 39 days (33-130 days). The valves involved were 5 (38%) aortic valves, 2 (15%) aortic + mitral valves, 3 (23%) mitral valves, 2 (16%) vegetation on the lead, and 1 (7%) in the pulmonary valve. In the underlying diseases, 5 (35%) had diabetes mellitus, 5 (35%) had hemodialysis, and 4 (30%) had pacemakers. One (7%) of the patients had a heart transplant, and 1 had a liver transplant. Seven (50%) had a prosthetic valve, and 7 (50%) had a natural valve. The detected microbiological factors are: 8 (57%) had Candida parapsilosis (C. parapsilosis), 5 (35%) Candida albicans (C. albicans) and 1 (7%) Candida tropicalis (C. tropicalis). There was a valve change in 7 (50%) of them. C. albicans grew in the valve culture of one patient. Fluconazole was used in 6 patients (43%), and echinocandins were used in 8 (57%) patients. Six patients (43%) died during 1-year follow-up. Embolism in the central nervous system was detected in 6 patients (43%) on magnetic resonance imaging (MRI). Conclusions: Candida endocarditis has a high mortality, and it is not easy to define the most appropriate treatment because of its rarity.