{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:02:54Z","timestamp":1756425774088,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,2,10]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>Cryptococcal species endocarditis is infrequently described, carries high mortality and nearly always occurs in immunocompromised states or on prosthetic valves. We report the case of a man in his 70s with multiple recent hospitalisations for pneumonia, hypercalcaemia and septic tank exposure who presented with intermittent fevers, progressive weakness,and worsening encephalopathy, manifested as confusion and word-finding difficulties for 3\u2009weeks. Workup revealed cryptococcal species on blood serum gram stain, native aortic valve endocarditis and meningitis. Cerebrospinal fluid analysis demonstrated lymphocytosis, ultimately found to be secondary to chronic lymphocytic leukaemia. Surgical valve replacement was deemed medically contraindicated and antifungal therapy was initiated. Though poorly understood with very few documented cases, management of cryptococcal endocarditis relies on prompt diagnosis, early surgery when indicated, long-term antifungal therapy and treatment of underlying immunocompromising states where possible.<\/jats:p>","DOI":"10.1136\/bcr-2021-247310","type":"journal-article","created":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T11:05:38Z","timestamp":1646219138000},"page":"e247310","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Overwhelming cryptococcosis complicated by cryptococcal endocarditis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4706-1738","authenticated-orcid":false,"given":"Wiaam","family":"Elkhatib","sequence":"first","affiliation":[{"name":"Internal Medicine, Mayo Clinic Hospital, Jacksonville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua Y","family":"Kwon","sequence":"additional","affiliation":[{"name":"Internal Medicine, Mayo Clinic Hospital, Jacksonville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5631-6595","authenticated-orcid":false,"given":"Michael B","family":"Phillips","sequence":"additional","affiliation":[{"name":"Internal Medicine, Mayo Clinic Hospital, Jacksonville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,2]]},"reference":[{"key":"2025082800473764000_15.3.e247310.1","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1016\/j.mayocp.2019.12.008","article-title":"Infective endocarditis: a contemporary review","volume":"95","author":"Hubers","year":"2020","journal-title":"Mayo Clin Proc"},{"key":"2025082800473764000_15.3.e247310.2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2008.603"},{"key":"2025082800473764000_15.3.e247310.3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.1.90"},{"key":"2025082800473764000_15.3.e247310.4","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.jiac.2019.05.003","article-title":"Cryptococcus endocarditis: a case report and review of the literature","volume":"25","author":"Nakajima","year":"2019","journal-title":"J Infect Chemother"},{"key":"2025082800473764000_15.3.e247310.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.046677"},{"key":"2025082800473764000_15.3.e247310.6","doi-asserted-by":"publisher","DOI":"10.1086\/317550"},{"key":"2025082800473764000_15.3.e247310.7","doi-asserted-by":"publisher","DOI":"10.1086\/313753"},{"key":"2025082800473764000_15.3.e247310.8","doi-asserted-by":"crossref","DOI":"10.1177\/0300060520970763","article-title":"Cryptococcal endocarditis of native valves without immunodeficiency or drug abuse: a case report","volume":"48","author":"Li","year":"2020","journal-title":"J Int Med Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-247310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:47:44Z","timestamp":1756367264000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-247310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3,2]]},"published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1136\/bcr-2021-247310"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-247310","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,3]]}}}