Dizziness Found to Be Candida Parapsilosis Prosthetic Valve Endocarditis

David F Painter1, Melissa M Jones1, Antoun Kamel1

  • 1Department of Internal Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.

PubMed

Insights

Candida parapsilosis can cause serious prosthetic valve endocarditis (PVE) after procedures. Early diagnosis and combined antifungal therapy with source control are crucial for managing this rare but severe fungal infection.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Mycology

Background:

  • Candida parapsilosis is an opportunistic pathogen known for biofilm formation and medical device adhesion.
  • Fungal prosthetic valve endocarditis (PVE) is a rare but serious complication of candidemia or direct contamination.
  • C. parapsilosis is a frequent cause of fungal endocarditis.

Purpose of the Study:

  • To present a case of disseminated candidemia and fungal PVE in a patient post-transcatheter aortic valve replacement.
  • To highlight diagnostic challenges in identifying the source of fungal endocarditis.
  • To emphasize the importance of early prosthetic valve evaluation in persistent fungemia.

Main Methods:

  • Case report of a 78-year-old male patient.
  • Clinical presentation: persistent dizziness and cerebellar stroke 2 months post-transcatheter aortic valve replacement.
  • Diagnosis: treatment-resistant disseminated candidemia and fungal PVE.

Main Results:

  • The patient's stroke and fungemia were secondary to fungal PVE.
  • The case illustrates difficulties in diagnosing the source of fungal endocarditis.
  • Persistent fungemia necessitates early consideration of prosthetic valve involvement.

Conclusions:

  • Optimal management of C. parapsilosis endocarditis involves prolonged antifungal therapy.
  • Definitive source control is essential for successful treatment.
  • Early recognition and management are critical for improving patient outcomes in fungal PVE.

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