Cryptococcus neoformans endocarditis in an immunocompetentpatient a case report

• Published in: BMC cardiovascular disorders Vol. 22; no. 1; pp. 565 - 6
• Main Authors: McGuire, Colin N., Walter, Dylan J.
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23.12.2022; BioMed Central; BMC
• Subjects: Case Report; Causes of; Cryptococcal endocarditis; Cryptococcal fungemia cardiac manifestations; Cryptococcal infection in heart failure; Cryptococcosis - complications; Cryptococcosis - diagnosis; Cryptococcosis - drug therapy; Cryptococcus; Cryptococcus neoformans; Cryptococcus neoformans valvular disease; Diagnosis; Endocarditis; Endocarditis - complications; Endocarditis - diagnosis; Endocarditis - microbiology; Health aspects; Humans; Immunocompromised host; Meningitis; Meningitis, Cryptococcal - microbiology; United States; Cryptococcal fungemia cardiac manifestations; Cryptococcal endocarditis; Cryptococcus neoformans valvular disease; Cryptococcal infection in heart failure
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-022-02997-9

Cryptococcus neoformans is an invasive fungal infection commonly affecting immunocompromised patients as pneumonia or meningitis. More rarely, case reports describe Cryptococcus neoformans endocarditis, though nearly exclusively among patients with active immunosuppression, implanted cardiac devices or prosthetic valves. We report the case of a patient with underlying substance abuse disorder and systolic heart failure presenting with fever, altered mental status, and shower emboli subsequently found to have native tricuspid valve vegetations and blood cultures positive for cryptococcus neoformans in the absence of immunosuppression. Historically, Cryptococcus neoformans fungemia manifests clinically as pneumonia or meningitis among the immunosuppressed. There have been rare reports of endocarditis in this population and even fewer reports of native valve endocarditis exist. The present case along with mortality reported in prior literature, suggest suspicion must be maintained in the absence of immunosuppression, even in patients with native valves.