RT Journal Article SR Electronic T1 Pacemaker-related Candida parapsilosis fungaemia in an immunosuppressed renal transplant recipient JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e242917 DO 10.1136/bcr-2021-242917 VO 14 IS 7 A1 Hebert, Josephine A1 Barr, Ellen A1 Magee, Colm YR 2021 UL http://casereports.bmj.com/content/14/7/e242917.abstract 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.