catastrophic candida prosthetic valve endocarditis and covid-19 comorbidity: a rare case

Background and purpose: coronavirus disease 2019 (covid-19) and candida prostatic valve endocarditis present various clinical manifestations which may overlap; hence, discrimination between them is extremely difficult. case report: the case was a 66-year-old man with a past medical history of mitral and aortic valves replacement one year before covid-19 co-infection. he was admitted with fever (for 7 days), shortness of breath, cough, seizure, lethargy, headache, and 85% oxygen saturation. transesophageal echocardiography revealed multiple large-sized, highly mobile masses on both sides of the mechanical mitral valve highly suggestive of vegetation. chest computed tomography scanning showed simulating scattered covid-19 peripheral ground-glass opacities confirmed by reverse-transcription polymerase chain reaction. the set of blood cultures yielded yeast colonies that were identified as candida tropicalis. the patient died of septic shock shortly after receiving antifungal therapy. conclusion: this case emphasized the importance of early diagnosis and implementation of antifungal treatment, particularly in patients with prosthetic cardiac valves, to reduce their unfavorable outcomes in covid-19 patients.