Prosthetic Mitral Valve Fungal Endocarditis

Fungal prosthetic valve endocarditis is described in a patient without significant comorbidities. Key questions guiding the discussion include the following. 1) What are the diagnostic criteria and major differential diagnoses? 2)What are the current surgical indications and optimal timing for prosthetic valve endocarditis? 3) How do mortality prediction scores inform surgical decision-making through risk stratification? 4) What medical treatment should be initiated, and what is the most appropriate antifungal regimen once the etiologic agent is identified? 5) What strategies ensure long-term follow-up and prevention of postoperative fungal reinfection? After initial antibiotic failure, the patient underwent successful reoperation, leading to the diagnosis of fungal infection, which was appropriately treated with antifungal therapy. TAKE-HOME MESSAGES: This case underscores the complexity of diagnosing fungal endocarditis and its high mortality risk, highlighting the critical role of a multidisciplinary team in achieving optimal management.