title: Concomitant stroke and Candida parapsilosis native valve endocarditis: report of one case and literature review.
abstract: Cerebrovascular stroke due to Candida (C.) parapsilosis native valve endocarditis (NVE) is rarely reported. Herein, we report a 53-year man with C. parapsilosis NVE and acute ischemic stroke. Diabetes mellitus and recent dental manipulation were the preceding events. Cranial magnetic resonance imaging study revealed occlusion of left common carotid artery, and infarcts of the pons and territory of the branch of left middle cerebral artery. With a total of 4,051 mg amphotericin B therapy and aortic valve replacement, the patient survived with right hemiplegia and dysarthria. In the English literature, there have been 12 patients with C. parapsilosis NVE including our patient over the past 25 years. Intravenous drug abuse was the most common predisposing factor for this infective disorder, followed by hematological malignancy and central venous catheterization. Fever and ischemic phenomenon of lower legs were the common clinical manifestations. Cerebrovascular stroke was present only in our case. Of these 12 patients, one administered fluconazole and miconazole therapy died, while 11 with amphotericin B therapy and one patient with fluconazole monotherapy survived.
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.
authors.forename: Chuei-Shiun
authors.initials: CS
authors.lastname: Li
authors.forename: Chi-Ren
authors.initials: CR
authors.lastname: Huang
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Lui
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Chien
authors.forename: Wen-Neng
authors.initials: WN
authors.lastname: Chang
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery; D001921:Brain / Q000000981:diagnostic imaging*; D002177:Candidiasis / Q000150:complications* / Q000188:drug therapy; D048909:Diabetes Complications; D004696:Endocarditis / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging; D014081:Tooth Extraction
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B