Acute ischemic stroke treated with mechanical thrombectomy and fungal endocarditis: A case report and systematic review of the literature

J Neuroradiol. 2020 Sep;47(5):386-392. doi: 10.1016/j.neurad.2019.03.003. Epub 2019 Apr 2.

Abstract

Fungal endocarditis is a rare clinical form of infective endocarditis. The main etiology of FE is Candida albicans but also Candida parapsilosis and the overall mortality is high. We report a case of an acute ischemic stroke treated by mechanical thrombectomy, with the histopathological analysis of the retrieved clot followed by the confirmation of fungal endocarditis. An extensive review of the literature has been proposed and three key points concerning the fungal endocarditis predisposing factors, the relation between thrombolysis and hemorrhagic risk and, finally, the importance of clot analysis have been discussed.

Keywords: Candida; Clot; Endocarditis; Histopathology; Stent; Stroke.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Candida parapsilosis / isolation & purification
  • Candidiasis / diagnostic imaging
  • Candidiasis / microbiology*
  • Candidiasis / therapy
  • Cerebral Angiography
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Embolization, Therapeutic
  • Endocarditis / diagnostic imaging
  • Endocarditis / microbiology*
  • Endocarditis / therapy
  • Humans
  • Ischemic Stroke / microbiology*
  • Ischemic Stroke / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Thrombectomy / methods*
  • Tomography, X-Ray Computed

Substances

  • Antifungal Agents