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You are here: Contents > 2017 > Volume 26 Number 5 September 2017 > CASE REPORTS > Isolated Pulmonary Valve Fungal Endocarditis with Candida parapsilosis: Management Considerations of a Rare Case

Isolated Pulmonary Valve Fungal Endocarditis with Candida parapsilosis: Management Considerations of a Rare Case

Nirmal Guragai1, Upamanyu Rampal2, Rahul Vasudev2,3, Dhaval Shah1, Hiten Patel2, Julius Salamera1, Raja Pullatt1, Fayez Shamoon2

1Department of Internal Medicine, Seton Hall University-Hackensack Meridian School of Medicine, Trinitas Regional Medical Center, Elizabeth, New Jersey, USA
2Department of Cardiology, New York Medical College at St. Joseph’s Regional Medical Center, Paterson, New Jersey, USA
3Electronic correspondence: nirmalguragai@yahoo.com

Pulmonary valve infections without the involvement of other valves account for only 1.5- 2% of all infective endocarditis cases. Isolated pulmonary valve endocarditis due to fungus is extremely rare. The case is presented of a 36-year-old male who was found to have isolated pulmonary valve endocarditis caused by a very rare organism, Candida parapsilosis, and that was solely managed with medical therapy. The patient was evaluated for three weeks of lowgrade fever, generalized rash and fatigue, and found to have C. parapsilosis in the blood. Transesophageal echocardiography (TEE)

 

demonstrated a 4.5 cm vegetation on the pulmonary valve, without involvement of other valves. The patient was deemed not to be a surgical candidate and was subsequently started on intravenous liposomal amphotericin B and 5-flucytosine, with excellent clinical outcome. Based on these case details, it must be emphasized that in selective cases and if there are no known complications, fungal endocarditis can be managed successfully using anti-fungal agents.

The Journal of Heart Valve Disease 2017;26:581-584


Isolated Pulmonary Valve Fungal Endocarditis with Candida parapsilosis: Management Considerations of a Rare Case

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