Malassezia furfur is a lipophilic yeast known to colonize indwelling catheters. Although progression to vasculitis and sepsis has been described, it has rarely caused fungemia in adults receiving nutrition via an indwelling catheter. Difficulty in diagnosis occurs as M furfur does not grow on routine culture media unless it is supplemented with fatty acids. We present the first case of M furfur fungemia in an adult, complicated by a pedunculated septic thrombus arising from the superior vena cava and extending into the right atrium. Removal of the catheter, amphotericin-B therapy, and surgical debridement were required for cure.