Introduction
Fungal endocarditis, though only responsible for about 2–4% of all
infective endocarditis, is associated with a significantly higher
mortality risk [1, 2]. Candida species are responsible for most
cases of fungal endocarditis, with C. albicans being the most
common fungus identified, followed by C. parapsilosis [3].C. parapsilosis is especially common in intravenous drug users
(IVDU) and patients receiving parenteral nutrition [4]. Prosthetic
heart devices, prolonged central venous lines, and immunocompromised
hosts are also established risk factors [5]. Its tendency to form
biofilms on foreign bodies may explain its relationship with vascular
devices and its pathogenic potential [6]. Most cases of C.
parapsilosis recorded thus far have either isolated prosthetic valve
involvement or, less frequently, isolated native valve involvement
[4]. We present a rare instance of a 44-year-old woman with a
history of intravenous drug abuse who presented with relapsing C.
parapsilosis endocarditis that initially affected the native aortic
valve, followed by relapse with C. parapsilosis fungemia, septic
embolization to the spleen, and involvement of the bioprosthetic aortic
valve.