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A Case of Infective Endocarditis in an End-Stage Renal Disease Patient Caused by Candida famata

말기신부전 환자에서 Candida famata에 의해 발생한 심내막염

  • Kim, Jeong Gwan (Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center) ;
  • Whang, Hyun Chul (Division of Nephrology, Department of Internal Medicine, Hyundae Jungang General Hospital) ;
  • Jang, Ji Yeon (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Seoul Saint Mary's Hospital) ;
  • Ha, Seong Eun (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Seoul Saint Mary's Hospital) ;
  • Kim, Dong Hwi (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Seoul Saint Mary's Hospital) ;
  • Choi, Bum Soon (Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Seoul Saint Mary's Hospital)
  • 김정관 (예수병원 신장내과) ;
  • 황현철 (현대중앙병원 신장내과) ;
  • 장지연 (가톨릭대학교 의과대학 내과학교실) ;
  • 하성은 (가톨릭대학교 의과대학 내과학교실) ;
  • 김동휘 (가톨릭대학교 의과대학 내과학교실) ;
  • 최범순 (가톨릭대학교 의과대학 내과학교실)
  • Received : 2013.05.08
  • Accepted : 2013.05.31
  • Published : 2014.03.01

Abstract

Infective endocarditis is rare in end-stage renal disease (ESRD) patients, who have a poorer prognosis than the general population. Candida endocarditis is rare and has a poor prognosis among causes of infective endocarditis. A 45-year-old male was admitted with sepsis combined with a hematoma on his right back. Candida famata was cultured in his blood. We treated him with antifungal agents. Echocardiography was performed to identify vegetations and diagnose endocarditis. In this case, surgical therapy was impossible because the patient's condition had deteriorated. We also administered antibiotics because methicillin-resistant Staphylococcus aureus was cultured from his sputum and a perianal abscess. The symptoms did not improve despite the ongoing treatment. Metabolic acidosis, hypotension, and a decreased state of consciousness developed and he died. We report a rare case of Candida endocarditis in an ESRD patient on hemodialysis.

혈액투석 중인 만성 신부전 환자에서 발생하는 진균성 심내막염은 일반적 감염성 심내막염보다 발생빈도는 적으나 예후는 좋지 않다. 그렇기 때문에 의심되는 소견을 보이면 경흉부 심장초음파와 함께 경식도 심장초음파의 적극적인 검사로 빠른 진단과 치료가 필요하다.

Keywords

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