PT  - JOURNAL ARTICLE
AU  - Hebert, Josephine
AU  - Barr, Ellen
AU  - Magee, Colm
TI  - Pacemaker-related <em>Candida parapsilosis</em> fungaemia in an immunosuppressed renal transplant recipient
AID  - 10.1136/bcr-2021-242917
DP  - 2021 Jul 01
TA  - BMJ Case Reports
PG  - e242917
VI  - 14
IP  - 7
4099  - http://casereports.bmj.com/content/14/7/e242917.short
4100  - http://casereports.bmj.com/content/14/7/e242917.full
SO  - BMJ Case Reports2021 Jul 01; 14
AB  - 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.