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Case report
Pacemaker-related Candida parapsilosis fungaemia in an immunosuppressed renal transplant recipient
  1. Josephine Hebert,
  2. Ellen Barr and
  3. Colm Magee
  1. Nephrology Department, Beaumont Hospital, Dublin, Ireland
  1. Correspondence to Dr Josephine Hebert; hebertj{at}tcd.ie

Abstract

Renal transplant recipients are at risk for opportunistic infections due to their immunosuppressed state. We describe the case of a 59-year-old renal transplant recipient who presented with sepsis and bilateral pulmonary emboli due to Candida parapsilosis. She was treated with intravenous caspofungin and had a transoesophageal echocardiogram, which revealed vegetations on her pacemaker leads. She then underwent surgery to replace her pacemaker; however, her blood cultures remained positive for C. parapsilosis postoperatively. Her antifungal was switched to liposomal amphotericin B and flucytosine for 6 weeks, which yielded sterile blood cultures, and she was then initiated on lifelong fluconazole. Her recovery was complicated by tacrolimus toxicity 1 month after discharge due to fluconazole-induced CYP3A inhibition.

  • renal transplantation
  • infectious diseases
  • COVID-19
  • renal system

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https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-242917

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    Footnotes

    • Contributors CM conceived the idea for this case report and provided guidance and critical revision of this article. JH and EB collected data and drafted the article and JH contributed to critical revision of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.