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Successful Surgical Intervention for the Management of Endocarditis due to Multidrug Resistant Candida parapsilosis: Case Report and Literature Review

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Abstract

Candida parapsilosis is an uncommon cause of invasive endocarditis. This pathogen induces severe complications and carries a high mortality rate. We describe a case of C. parapsilosis endocarditis in a 54-year-old man with a history of HIV and Hepatitis C infection who previously underwent prosthetic valve replacement due to bacterial endocarditis. The patient presented with prolonged febrile episodes and fungemia with repeat blood cultures positive for C. parapsilosis. The patient failed multiple regimens of antifungal therapy and the C. parapsilosis isolate progressively acquired resistance to a number of drugs. Due to the multidrug resistant nature of the isolate, replacement of the infected valve was required to resolve his fungemia, and the patient remained asymptomatic for two years. This case is unusual due to the multidrug resistant nature of the isolate requiring both combined medical and surgical intervention. A review of published reports indicates that endocarditis due to C. parapsilosis responds well to a combination of medical and surgical interventions; the latter is particularly suitable for immunocompromised hosts.

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Acknowledgments

We thank Dr. Robert Jellinger for his clinical expertise in the management of the patient, Dr. Richard Blinkhorn for editorial assistance and the support of the Wadsworth Center for diagnostic testing.

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Authors and Affiliations

  1. Department of Internal Medicine and Pediatrics, Albany Medical College, Albany, NY, USA

    Jessica Kumar

  2. AIDS Treatment Center and Department of Medicine, Albany, NY, USA

    Douglas Fish

  3. HIV Research Wadsworth Center of New York State, Albany, NY, USA

    Harold Burger & Barbara Weiser

  4. Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA

    Jeffrey S. Ross

  5. Department of Pathology, Albany Medical Center, Albany, NY, USA

    David Jones & Karl Robstad

  6. Department of Health, Mycotic and Parasitic Diseases New York State, Department of Health Mycology Laboratory, Wadsworth Center of the New York State, Albany, NY, USA

    Xiaojiang Li

  7. Department of Health, Mycotic and Parasitic Diseases New York State, Department of Health Mycology Laboratory, Albany, NY, USA

    Vishnu Chaturvedi

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  1. Jessica Kumar
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Correspondence to Jessica Kumar.

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Kumar, J., Fish, D., Burger, H. et al. Successful Surgical Intervention for the Management of Endocarditis due to Multidrug Resistant Candida parapsilosis: Case Report and Literature Review. Mycopathologia 172, 287–292 (2011). https://doi.org/10.1007/s11046-011-9430-x

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  • DOI: https://doi.org/10.1007/s11046-011-9430-x

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