frequency of fungal endocarditis

Q: Arterial embolization from fungal endocarditis is more common than bacterial endocarditis.

A) True

B) False

Answer: A

Fungal endocarditis tends to have a higher incidence of arterial embolization than bacterial endocarditis. The most probable reason is the larger size of the vegetations. These embolizations tends to go and seed in brain, limbs and GI tract. Stigmatas of bacterial endocarditis can be present such as Osler nodes, Roth spots, and Janeway lesions.  

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References:

1. Ellis ME, Al-Abdely H, Sandridge A, et al. Fungal endocarditis: evidence in the world literature, 1965-1995. Clin Infect Dis 2001; 32:50.

2. Rubinstein E, Noriega ER, Simberkoff MS, et al. Fungal endocarditis: analysis of 24 cases and review of the literature. Medicine (Baltimore) 1975; 54:331. 

3. Yuan SM. Fungal Endocarditis. Braz J Cardiovasc Surg. 2016 May-Jun;31(3):252-255. doi: 10.5935/1678-9741.20160026. PMID: 27737409; PMCID: PMC5062704. 

4. Pasha AK, Lee JZ, Low SW, Desai H, Lee KS, Al Mohajer M. Fungal Endocarditis: Update on Diagnosis and Management. Am J Med. 2016 Oct;129(10):1037-43. doi: 10.1016/j.amjmed.2016.05.012. Epub 2016 Jun 4. PMID: 27267285.