Final answer:
Fungal endocarditis requires antifungal therapy, with the most common treatment being a combination of amphotericin B and flucytosine. These drugs target fungal cell membranes, and treatment must be carefully monitored. Lifelong suppressive therapy may be needed for immunocompromised patients.
Step-by-step explanation:
Empiric Treatment of Fungal Endocarditis
Fungal endocarditis is a serious, life-threatening condition, particularly in immunocompromised individuals. When fungal infections are suspected, diagnostic procedures typically include a series of laboratory tests such as blood cultures, microscopic examination, and sometimes serological tests. Unlike bacterial endocarditis, which is treated with specific antibiotic regimens, fungal endocarditis requires antifungal therapy.
Commonly, a combination of amphotericin B and flucytosine is used to treat these infections. Amphotericin B targets fungal cell membranes, however, due to potential side effects on host cells, careful monitoring is necessary. Treatment is lengthy, often requiring a continuation with fluconazole for several months post-treatment.
For specific fungal pathogens such as Cryptococcus, individuals may need lifelong suppressive therapy, particularly if they are immunocompromised. Other antifungal drugs, such as voriconazole and itraconazole, may be used for treating different fungal infections like aspergillosis.