Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/33880
Type
ArticleCopyright
Open access
Collections
- INI - Artigos de Periódicos [3495]
Metadata
Show full item record
OUTCOMES IN PATIENTS WITH FUNGAL ENDOCARDITIS: A MULTICENTER OBSERVATIONAL COHORT STUDY
Author
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
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
Affilliation
University of São Paulo. Medical School. Heart Institute. Infection Control Team. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Infection Control Team. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Infection Control Team. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
Instituto do Câncer do Estado de São Paulo. Infection Control Team. São Paulo, SP, Brazil.
Instituto Nacional de Cardiologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Cardiologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Cardiologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Cardiologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Rio de Janeiro, RJ, Brasil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Infection Control Team. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Infection Control Team. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Infection Control Team. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
Instituto do Câncer do Estado de São Paulo. Infection Control Team. São Paulo, SP, Brazil.
Instituto Nacional de Cardiologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Cardiologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Cardiologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Cardiologia do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Rio de Janeiro, RJ, Brasil.
University of São Paulo. Medical School. Heart Institute. Cardiology Department. São Paulo, SP, Brazil.
University of São Paulo. Medical School. Heart Institute. Infection Control Team. São Paulo, SP, Brazil.
Abstract
Objective: 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. Methods: 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. Results: 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). Conclusions: 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.
Share