Successful treatment of Candida parapsilosis mural endocarditis with combined caspofungin and voriconazole

Background: Fungal mural endocarditis is a rare entity in which the antemortem diagnosis is seldom made. Seven cases of mural endocarditis caused by Candida spp. have been collected from literature and six of these patients died after treatment with amphotericin B. Case presentation: We report a case of mural endocarditis diagnosed by transesophageal echocardiogram and positive blood cultures to Candida parapsilosis. Because blood cultures continued to yield C. parapsilosis despite caspofungin monotherapy, treatment with voriconazole was added. Conclusion: This is the first description of successful treatment of C. parapsilosis mural endocarditis with caspofungin and voriconazole.