Acute ischemic stroke treated with mechanical thrombectomy and fungal endocarditis: A case report and systematic review of the literature - 18/04/19

Doi : 10.1016/j.neurad.2019.03.003

Alessandro Sgreccia ^a,^⁎ , Giuseppe Carità ^b, Oguzhan Coskun ^c, Federico Di Maria ^c, Hakim Benamer ^d, Marie Tisserand ^c, Anthony Scemama ^d, Georges Rodesch ^c, Bertrand Lapergue ^e, Arturo Consoli ^c
^a Department of Radiology, Ospedali Riuniti, Ancona, Italy
^b Department of Radiology, Azienda Ospedaliero Universitaria Ferrara, Ospedale Sant’ Anna Cona, Ferrara, Italy
^c Department of Diagnostic and Interventional Neuroradiology, Foch Hospital, Suresnes, France
^d Department of Cardiology, Foch Hospital, Suresnes, France
^e Division of Neurology, Stroke Center, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France

^⁎Corresponding author at: Department of Radiology, Ospedali Riuniti, via Conca, 71, 60126 Torrette, Ancona AN, Italy.Department of Radiology, Ospedali Riunitivia Conca, 71TorretteAncona AN60126Italy

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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.

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Keywords : Stroke, Candida, Endocarditis, Clot, Histopathology, Stent