Nadir Eyal, Rubinstein Ethan
Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, 52621, Tel-Aviv University, School of Medicine, Israel.
Curr Infect Dis Rep. 2004 Aug;6(4):276-282. doi: 10.1007/s11908-004-0048-8.
Recent advances in medicine have caused fungal endocarditis (FE) to be a more common disease entity. Many fungi are potential pathogens in FE, although Candida species and Aspergillus species are the most common. Valvular heart disease is the necessary underlying condition for FE, with intravenous devices and antibiotic use being the predisposing factors for yeast endocarditis, whereas immunosuppression in patients with valvulopathy predisposes for mold endocarditis. Better prognosis of FE depends on fast and accurate diagnosis and subsequent treatment. Echocardiography was the most valuable recent technique in the past two decades that allowed early diagnosis of FE and is probably responsible for the improved prognosis of patients with FE. In the future, development of nonculture-based diagnostic tests may further improve the sensitivity, specificity, and rapidity of microbiologic diagnosis of FE. Novel approaches in treatment, such as new antifungal drugs, also may assist in achieving cure and further improving the prognosis of this disease entity.
医学上的最新进展使真菌性心内膜炎(FE)成为一种更为常见的疾病实体。许多真菌都是FE的潜在病原体,尽管念珠菌属和曲霉属最为常见。瓣膜性心脏病是FE的必要基础疾病,静脉内装置的使用和抗生素的使用是酵母性心内膜炎的诱发因素,而瓣膜病患者的免疫抑制则易引发霉菌性心内膜炎。FE更好的预后取决于快速准确的诊断及后续治疗。在过去二十年中,超声心动图是最有价值的最新技术,它能够实现FE的早期诊断,这可能是FE患者预后改善的原因。未来,基于非培养的诊断测试的发展可能会进一步提高FE微生物诊断的敏感性、特异性和快速性。新的治疗方法,如新的抗真菌药物,也可能有助于实现治愈并进一步改善这种疾病实体的预后。