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Open Access Highly Accessed Case report

Successful treatment of Candida parapsilosis mural endocarditis with combined caspofungin and voriconazole

Víctor López-Ciudad1*, María J Castro-Orjales1, Cristóbal León2, César Sanz-Rodríguez3, María J de la Torre-Fernández1, Miguel A Pérez de Juan-Romero4, María D Collell-Llach4 and María D Díaz-López5

Author Affiliations

1 Intensive Care Unit, Hospital Santa María Madre-Complejo Hospitalario de Ourense, Ourense, Spain

2 Intensive Care Unit and Emergency Service, Hospital Universitario de Valme, Sevilla, Spain

3 Department of Clinical Research, Merck Sharp & Dohme de España, S.A. Madrid, Spain

4 Department of Cardiology, Hospital Santa María Madre-Complejo Hospitalario de Ourense, Ourense, Spain

5 Unit of Infectious Diseases, Hospital Santa María Madre-Complejo Hospitalario de Ourense, Ourense, Spain

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BMC Infectious Diseases 2006, 6:73  doi:10.1186/1471-2334-6-73

Published: 11 April 2006

Abstract

Background

Fungal mural endocarditis is a rare entity in which the antemortem diagnosis is seldom made. Seven cases of mural endocarditis caused by Candida spp. have been collected from literature and six of these patients died after treatment with amphotericin B.

Case presentation

We report a case of mural endocarditis diagnosed by transesophageal echocardiogram and positive blood cultures to Candida parapsilosis. Because blood cultures continued to yield C. parapsilosis despite caspofungin monotherapy, treatment with voriconazole was added.

Conclusion

This is the first description of successful treatment of C. parapsilosis mural endocarditis with caspofungin and voriconazole.