title: Candida parapsilosis endocarditis that emerged 2 years after abdominal surgery.
abstract: A 22-year-old man was hospitalized after 3 months of persistent fever and malaise. He had undergone abdominal surgery 24 months before admission. Echocardiography demonstrated two mobile pedunculated masses in the right ventricle. Multiple blood cultures were positive for Candida parapsilosis. After 4 weeks of miconazole treatment, the two masses were excised via a right atriotomy incision and the transtricuspid value approach. Histological examination revealed that they were fungal vegetation. Antifungal agents were continued for 1 year after surgery. The patient has remained well with no further symptoms for 3 years. This case suggests the necessity for careful evaluation of past history to avoid diagnostic delay in fungal endocarditis.
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Tonomo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsujino
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Fujioka
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakao
authors.forename: Hideki
authors.initials: H
authors.lastname: Yao
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yasoshima
authors.forename: Akira
authors.initials: A
authors.lastname: Kubota
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Ohyanagi
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D008825:Miconazole / Q000627:therapeutic use; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D000935:Antifungal Agents; D008825:Miconazole