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Relapse of Candida parapsilosis Endocarditis After Long-Term Suppression with Flucytosine: Retreatment with Valve Replacement and Ketoconazole

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▸Requests for reprints should be addressed to Stephen A. Lerner, M.D.; Box 415, University of Chicago School of Medicine, 950 East 59th Street; Chicago, IL 60637.

University of Chicago School of Medicine; Chicago, Illinois.

Ann Intern Med. 1980;93(6):838-839. doi:10.7326/0003-4819-93-6-838
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Fungal endocarditis responds poorly to medical therapy (1, 2). Therapeutic recommendations now include early surgery and aggressive use of antifungal drugs (3, 4). With increasing numbers of reports of late relapses, the definition of cure has now come into doubt (2, 5). We describe here a case of Candida parapsilosis endocarditis in a patient who relapsed after 7 years of suppressive therapy with flucytosine.

A 36-year-old female heroin abuser developed C. parapsilosis mitral valve endocarditis in September 1970. She needed excision of the infected valve and replacement with a #27 Björk-Shiley mitral valve prosthesis. After surgery the patient received 1.12


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