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Siciliano, Rinaldo Focaccia; Gualandro, Danielle Menosi; Sejas, Odeli Nicole Encinas; Ignoto, Bruno Giuliano; Caramelli, Bruno; Mansur, Alfredo Jose; Sampaio, Roney Orismar; Pierrotti, Ligia Camera; Barbosa, Giovanna; Golebiovski, Wilma; Weksler, Clara; Lamas, Cristiane; Fortes, Natália Rodrigues Querido; Fortes, Claudio Querido; Tarasoutchi, Flavio; Strabelli, Tania Mara Varejão
International journal of infectious diseases, December 2018, 2018-Dec, 2018-12-00, 20181201, 2018-12-01, Letnik: 77Journal Article
•Patients with isolated right-sided fungal endocarditis had better survival.•Heart failure/medical treatment only were related to death in Candida endocarditis.•Isolated right-sided endocarditis a less harmful illness in Candida endocarditis. To compare the clinical and epidemiological features, treatments, and outcomes of patients with isolated right-sided and left-sided fungal endocarditis and to determine the risk factors for in-hospital mortality in patients with Candida sp endocarditis. A retrospective review of all consecutive cases of fungal endocarditis from five hospitals was performed. Clinical features were compared between patients with isolated right-sided and left-sided endocarditis. In the subgroup of fungal endocarditis due to Candida species, binary logistic regression analysis was performed to determine variables related to in-hospital mortality. Seventy-eight patients with fungal endocarditis were studied. Their median age was 50 years; 55% were male and 19 patients (24%) had isolated right-sided endocarditis. Overall, cardiac surgery was performed in 46 patients (59%), and in-hospital mortality was 54%. Compared to patients with left-side fungal endocarditis, patients with isolated right-sided endocarditis had lower mortality (32% vs. 61%; p=0.025) and were less often submitted to cardiac surgery (37% vs. 66%; p=0.024). The most frequent etiology was Candida spp (85%). In this subgroup, acute heart failure (odds ratio 5.0; p=0.027) and exclusive medical treatment (odds ratio 11.1; p=0.004) were independent predictors of in-hospital death, whereas isolated right-sided endocarditis was related to a lower risk of mortality (odds ratio 0.13; p=0.023). Patients with isolated right-sided fungal endocarditis have particular clinical and epidemiological features. They were submitted to cardiac surgery less often and had better survival than patients with left-sided fungal endocarditis. Isolated right-sided endocarditis was also a marker of a less harmful illness in the subgroup of Candida sp endocarditis.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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