Dizziness Found to Be Candida Parapsilosis Prosthetic Valve Endocarditis.

Candida parapsilosis is an opportunistic pathogen with a propensity for biofilm formation and adhesion to medical devices. Although rare, fungal prosthetic valve endocarditis (PVE) is a feared complication of disseminated candidemia or direct intraoperative contamination from fungal adherence to prosthetic valves. C. parapsilosis is one of the most common species underlying fungal endocarditis. We present a 78-year-old male patient 2 months after transcatheter aortic valve replacement with persistent dizziness and a cerebellar stroke found to be secondary to treatment-resistant disseminated candidemia and fungal PVE. This case highlights the diagnostic challenges of source identification in fungal endocarditis and reinforces the importance of considering prosthetic valve involvement early in the evaluation of persistent fungemia. Optimal management of C. parapsilosis endocarditis requires prolonged antifungal therapy as well as definitive source control.