Catastrophic Candida prosthetic valve endocarditis and COVID-19 comorbidity: A rare case

Lotfollah  Davoodi; Leila  Faeli; Rogheye  Mirzakhani; Rozita   Jalalian; Tahereh   Shokohi; Firoozeh  Kermani

doi:10.18502/cmm.7.2.7157

Lotfollah Davoodi Antimicrobial Resistance Research Center, Communicable Diseases Institute, and Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
Leila Faeli Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
Rogheye Mirzakhani Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
Rozita Jalalian Department of Cardiology, Mazandaran University of Medical Sciences, Sari, Iran
Tahereh Shokohi Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
Firoozeh Kermani Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

DOI: https://doi.org/10.18502/cmm.7.2.7157

Keywords: Candida endocarditis Case report Comorbidity COVID-19 Prosthetic valve replacement SARS-CoV-2 Transesophageal echocardiography

Abstract

Background and Purpose: Coronavirus disease 2019 (COVID-19) and Candida prostatic valve endocarditis present various clinical manifestations which may overlap;hence, discrimination between them is extremely difficult.

Case report: The case was a 66-year-old man with a past medical history of mitral and aortic valves replacement one year before COVID-19 co-infection. He was admitted with fever (for 7 days), shortness of breath, cough, seizure, lethargy,headache, and 85% oxygen saturation. Transesophageal echocardiography revealed multiple large-sized, highly mobile masses on both sides of the mechanical mitral valve highly suggestive of vegetation. Chest computed tomography scanning showed simulating scattered COVID-19 peripheral ground-glass opacities confirmed by reverse-transcription polymerase chain reaction. The set of blood cultures yielded yeast colonies that were identified as Candida tropicalis. The patient died of septic shock shortly after receiving antifungal therapy.

Conclusion: This case emphasized the importance of early diagnosis and implementation of antifungal treatment, particularly in patients with prosthetic cardiac valves, to reduce their unfavorable outcomes in COVID-19 patients.