Akritidou Olympia, Peristeri Athanasia-Marina, Lymperatou Diamantina, Prokopidou Anastasia, Christaki Eirini, Nikopoulou Anna
Department of Internal Medicine, G. Papanikolaou General Hospital of Thessaloniki, 57010 Thessaloniki, Greece.
First Department of Internal Medicine and Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece.
J Clin Med. 2025 Aug 30;14(17):6149. doi: 10.3390/jcm14176149.
: Fungal endocarditis (FE), is a rare yet life-threatening disease, which predominantly affects immunocompromised individuals, prosthetic valve recipients, and injection drug users. The purpose of this review is to summarize the evolving epidemiological trends, diagnostic challenges, and treatment strategies, by identifying evidence that supports the optimal clinical approach. : A literature search was performed, drawing from sources such as PubMed and Google Scholar and included articles published between January 2015 and March 2025. Clinical studies, case series, and meta-analyses reporting on FE epidemiology, diagnostics, or treatment were included. : The majority of FE cases is caused by species, predominantly , while accounted for a lesser percentage of cases. While blood cultures showed limited sensitivity, adjunctive diagnostic tools such as serum biomarkers (β-D-glucan, galactomannan) and advanced imaging modalities (18F-FDG PET/CT) are increasingly used to guide the diagnostic process. Early surgical intervention combined with antifungals improved survival, particularly for , although comprehensive data regarding this approach remains limited due to the rarity of the disease. : Fungal endocarditis requires an aggressive treatment strategy, integrating early surgery, targeted antifungals, and long-term suppression, especially for prosthetic valves. Despite advances, the complexity of the condition and the variety of the pathogens involved, continue to impede progress towards effective management of FE. Future research must prioritize rapid diagnostics, standardized treatment protocols, and novel antifungals to address this critical condition.
真菌性心内膜炎（FE）是一种罕见但危及生命的疾病，主要影响免疫功能低下者、人工瓣膜接受者和注射吸毒者。本综述的目的是通过识别支持最佳临床方法的证据，总结不断演变的流行病学趋势、诊断挑战和治疗策略。进行了文献检索，检索来源包括PubMed和谷歌学术等，并纳入了2015年1月至2025年3月发表的文章。纳入了关于FE流行病学、诊断或治疗的临床研究、病例系列和荟萃分析。大多数FE病例由 种引起，主要是 ，而 占病例的比例较小。虽然血培养显示敏感性有限，但血清生物标志物（β-D-葡聚糖、半乳甘露聚糖）和先进成像模式（18F-FDG PET/CT）等辅助诊断工具越来越多地用于指导诊断过程。早期手术干预联合抗真菌药物可提高生存率，特别是对于 ，尽管由于该疾病罕见，关于这种方法的综合数据仍然有限。真菌性心内膜炎需要积极的治疗策略，包括早期手术、靶向抗真菌药物和长期抑制，尤其是对于人工瓣膜。尽管取得了进展，但病情的复杂性和所涉及病原体的多样性继续阻碍FE有效管理的进展。未来的研究必须优先考虑快速诊断、标准化治疗方案和新型抗真菌药物，以应对这一关键疾病。
