Treatment of Infective Endocarditis Due to Fungi (Candida spp. or Aspergillus spp.)
Clinical Scenario
This protocol addresses infective endocarditis caused by fungal organisms — specifically
Candida species or Aspergillus species. Fungal endocarditis represents a
distinct and particularly challenging subset of infective endocarditis, with management
that differs substantially from bacterial causes.
Specific Conditions
The causative organism matters: Candida spp. and Aspergillus spp.
require different antifungal strategies. Identifying the genus — and obtaining blood
culture data — directly shapes the treatment path.
Treatment Approach (Partial Overview)
Management involves combined antifungal administration paired with a low threshold for
surgical intervention. The antifungal regimen differs depending on whether the causative
organism is Candida or Aspergillus — specific agent selection and
combination strategies apply to each.
Full regimen details, agent selection, and combination strategies are available in the structured protocol →
References
DOI: 10.1093/eurheartj/ehad193
- Antifungal therapy for Candida IE includes an echinocandin at high doses or liposomal amphotericin B (or other lipid formulations) with or without flucytosine.
- For Aspergillus IE, voriconazole is the drug of choice.
- Some experts recommend the addition of an echinocandin or amphotericin B.
View source ↗