First Reported Case of Candida dubliniensis Endocarditis Related to Implantable Cardioverter-Defibrillator

A 36-year-old male presented to the ED with acute chronic hyponatremia found on routine weekly lab work with one-week history of generalized weakness, confusion, nausea/vomiting, and diarrhea. The patient has nonischemic cardiomyopathy of unknown etiology diagnosed in his teens with an AICD device p...

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Bibliographic Details
Published in:Case reports in cardiology 2020, Vol.2020 (2020), p.1-9
Main Authors: Naguib, M. Tarek, James, Shanna, Mohammedzein, Assad, Bainum, Taryn B., Lung, John, Merza, Nooraldin, Saadaldin, Mazin
Format: Article
Language:English
Subjects:
Age
Cardiomyopathy
Cardiovascular disease
Case Report
Case reports
Catheters
Defibrillators
Disease prevention
Endocarditis
Family medical history
Heart failure
Heart rate
Infections
Mortality
Patients
Pulmonary hypertension
Ultrasonic imaging
Vegetation
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Summary:A 36-year-old male presented to the ED with acute chronic hyponatremia found on routine weekly lab work with one-week history of generalized weakness, confusion, nausea/vomiting, and diarrhea. The patient has nonischemic cardiomyopathy of unknown etiology diagnosed in his teens with an AICD device placed 8 years ago and receiving milrinone infusion 3 years ago via peripherally inserted central catheter (PICC) line. Two sets of blood cultures grew Candida dubliniensis. The patient was started on micafungin and the PICC line was removed and replaced with a central line. A transthoracic echocardiogram (TEE) showed findings consistent with AICD lead involvement. The patient was continued on treatment for fungal infective endocarditis and transferred to another hospital where he had successful AICD lead extraction. Blood cultures upon transfer back to our facility were positive for methicillin-sensitive Staphylococcus aureus (MSSA). This bacteremia was thought to be secondary to right-sided internal jugular (IJ) central line and resolved with line removal and initiation of intravenous (IV) cefazolin. The patient was discharged on IV cefazolin and IV micafungin. He had a LifeVest® until completion of his antibiotic course and a new AICD was placed.
ISSN:2090-6404
2090-6412
DOI:10.1155/2020/6032873