title: Fungal Prosthetic Valve Endocarditis by Candida parapsilosis: A Case Report.
abstract: BACKGROUND
  Fungal prosthetic valve endocarditis (PVE) is rare but serious complication of valve replacement surgery. Candida species, particularly Candida albicans is the most common isolated pathogen in fungal PVE (1-6%of cases).
  
  
  METHODS
  We describe a 35-year-old woman who underwent mechanical mitral valve replacement about 3 years ago. She was admitted with neurological symptoms and later with dyspnea and hypotension. Transesophageal echocardiography showed large and mobile prosthetic valve vegetation. She underwent mitral valve surgery. The explanted valve and vegetation revealed lots of budding yeasts and the isolated yeast was identified as C. parapsilosis. Amphotericin B and broad spectrum antibiotic were started immediately. Unfortunately, the patient died two days after surgery, due to sepsis probably related to the candidemia.
  
  
  CONCLUSIONS
  Fungal endocarditis is uncommon infection, but it is a serious problem in patients with prosthetic valve. Fungal PVE can occur years after the surgery, thus long-term follow-up is essential.
authors.affiliation: Department of Parasitology and Mycology, Mazandaran University of Medical Sciences, Sari, IR Iran ; Invasive Fungi Research center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Shokohi
authors.affiliation: Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Seyed Mahmood
authors.initials: SM
authors.lastname: Nouraei
authors.affiliation: Department of Parasitology and Mycology, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Mohammad Hosein
authors.initials: MH
authors.lastname: Afsarian
authors.affiliation: North Infectious Disease Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Najafi
authors.affiliation: Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Shirin
authors.initials: S
authors.lastname: Mehdipour
keywords: Candida; Endocarditis; Fungi; Prosthetic valve