FUNGAL ENDOCARDITIS - A REPORT ON 7 CASES AND A BRIEF REVIEW

Candida endocarditis is an unusual but severe complication of systemic infection caused by Candida albicans and occasionally by other fungal species. We describe seven cases that occurred during a period of 20 years in western Sweden. In four cases infections were located on pros thetic valves and in three cases native valves were involved. Three pa tients died of the disease in the acute phase. A definite diagnosis wa s established in one of four survivors. This patient had an aortic val ve endocarditis and a saddle embolisation and was treated with immedia te surgery, followed by intensive treatment with liposomal amphoterici n B + flucytosine. Fungal endocarditis is still a serious disease with a high mortality and whenever the diagnosis is suspected, antifungal therapy must be started and transesophageal sonography should be perfo rmed to visualize vegetations. Immediate surgery should be considered.