Prosthetic Valve Endocarditis Due to Candida Parapsilosis- a Rare Case Report

Fungal endocarditis is a rare and fatal condition , most frequently caused by the Candida and Aspergillus species. Fever and changing heart murmur are the most common clinical manifestations. The diagnosis of fungal endocarditis is challenging, especially that of prosthetic valve endocarditis is extremely difficult. The optimal management of the condition still remains debatable. We hereby present a case of prosthetic valve endocarditis caused by Candida parapsilosis , managed empirically with liposomal amphotericin B and later on was shifted to combination therapy with high dose echinocandin and fluconazole, but had a fatal outcome because he could not undergo timely surgical intervention. Treating Candida parapsilosis endocarditis cases are difficult because of their ability of biofilm production on native and prosthetic heart valves. A combined approach consisting of high index of clinical suspicion, early diagnosis by using serological markers followed by culture or PCR and prompt initiation of appropriate antifungals may aid in improving the outcome.