Right Heart Fungal Endocarditis in a 6-Month-Old Infant: A Case of Candida albicans Infection

Abstract

Fungal endocarditis (FE) is a rare but life-threatening condition, most commonly caused by Candida albicans. It typically occurs in patients with risk factors such as central venous catheters, immunosuppression, or prosthetic devices. Despite antifungal treatment, FE carries a poor prognosis. This report presents a rare case of C. albicans endocarditis in an immunocompetent 6-month-old infant with a central venous catheter. The child was initially admitted for febrile respiratory distress and treated for pneumonia. However, sudden clinical deterioration with sinus bradycardia prompted cardiac evaluation, revealing a right atrial mass. Blood and catheter cultures confirmed C. albicans, and labs showed severe inflammation and organ dysfunction. Despite antifungal therapy and catheter removal, the infant developed disseminated intravascular coagulation and died from septic shock. This case illustrates the increasing incidence of invasive fungal infections linked to ICU procedures and highlights the virulence of C. albicans, which can cause rapid tissue invasion and valvular involvement. Clinical presentation may mimic bacterial endocarditis but is often less specific. Diagnosis is challenging and requires blood cultures and echocardiography, especially transesophageal. Effective management involves prompt antifungal therapy—typically amphotericin B or echinocandins—and often surgery.