Recurrent fungal endocarditis of the aortic valve: A challenging clinical scenario.

Key Clinical Message: Fungal endocarditis is a rare but potentially fatal infection with significant diagnostic and management challenges. Antifungal therapy and surgical debridement are the preferred treatments in these cases. Antimicrobial therapy with multiple antifungal agents may be required in high-risk patients presenting with prolonged fever suspected of having fungal endocarditis.

Abstract: Recurrent fungal endocarditis, particularly involving Candida parapsilosis, is a rare and challenging clinical entity with limited management guidelines. We present the case of a 44-year-old female with a history of intravenous drug use and treatment-resistant chronic hepatitis C who developed recurrent Candida parapsilosis endocarditis. Initially, she presented with native aortic valve fungal endocarditis, which was managed with antifungal therapy and surgical aortic valve replacement. Despite this intervention, she experienced a subsequent episode of prosthetic valve Candida parapsilosis endocarditis, further complicated by prolonged fungemia. This case underscores the complexities of managing recurrent fungal endocarditis and highlights the need for ongoing research to refine treatment strategies for this challenging condition.