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Case Reports
. 2021 Jan 5;20(1):1.
doi: 10.1186/s12941-020-00409-4.

A case series of medically managed Candida parapsilosis complex prosthetic valve endocarditis

Penghao Guo  1 , Yuting He  1 , Rui Fan  2 , Zhongwen Wu  1 , Yili Chen  1 , Yuli Huang  3 , Kang Liao  4 , Peisong Chen  5
Affiliations
Case Reports

A case series of medically managed Candida parapsilosis complex prosthetic valve endocarditis

Penghao Guo et al. Ann Clin Microbiol Antimicrob. .

Abstract

Background: In recent years, Candida parapsilosis is recognized as a species complex and is composed of Candida parapsilosis sensu stricto, Candida orthopsilosis and Candida metapsilosis. Candida parapsilosis complex prosthetic valve endocarditis (PVE) is rare and the survival rate is still low despite of optimal therapeutic strategies. In our report, it is novel to report cases as Candida parapsilosis complex PVE at species and identify Candida parapsilosis using MALDI-TOF MS. Case presentation A series of 4 cases of Candida parapsilosis complex PVE from our institution was reported. Three were infected by Candida parapsilosis sensu stricto and one was infected by Candida metapsilosis. The condition of two cases got better and the other died.

Conclusions: More attention should be paid to Candida parapsilosis complex PVE and early diagnosis and prompt antibiotic therapy may play a role in the treatment for Candida parapsilosis complex PVE. It is recommended to identify Candida parapsilosis complex at species level and MALDI-TOF MS as an easy, fast and efficient identification method is worth promoting in clinical microbiology.

Keywords: Candida parapsilosis complex; Combination antifungal therapy; Matrix-assisted laser desorption ionization-time of flight mass spectrometry; Prosthetic valve endocarditis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The Candida parapsilosis complex prosthetic valve endocarditis of case 1. a Echocardiography showed a vegetation on the artificial mitral valve. b The Color Doppler showed increased flow rate at the prosthetic mitral valve orifice and tricuspid regurgitation (moderate)
Fig. 2
Fig. 2
The Candida parapsilosis complex prosthetic valve endocarditis of case 2. a Echocardiography showed a short abnormal strip about 5mm×3mm on the prosthetic mitral valve of the left atrium side; b The Color Doppler showed perivalvular leakage (moderate-severe); c Transesophageal 3D image showing a bioprosthetic mitral valve. A perivalvular crack about 10.3×6.1 mm could be seen around the medial side of the prosthetic mitral valve
Fig. 3
Fig. 3
The Candida parapsilosis complex prosthetic valve endocarditis of case 3. a TTE showed a hypoechoic vegetation on the artificial aortic valve and the vegetation was about 17.8×8.0 mm; b Mild to moderate mitral regurgitation and moderate tricuspid regurgitation were observed on Doppler color view
See this image and copyright information in PMC

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