Echocardiographic features of Candida species endocarditis: 12 cases and areview of published reports

Objective-To describe the specific echocardiographic features of Candida sp ecies endocarditis. Design-Retrospective review of the case records of patients with confirmed candida endocarditis. Setting-Cases referred to three French university centres over an eight yea r period were studied. Design-12 patients with confirmed Candida species endocarditis infection we re identified. The transthoracic (n = 12) and transoesophageal (n = 12) ech ocardiographic appearances were compared with the surgical findings (n = 10 ). Results-Large dense heterogeneous vegetations were found in 11/12 cases. A hyperechogenic heterogeneous myocardial texture, observed in seven of the 1 2 patients, was associated with extensive myocardial damage at surgery. Whi le it was possible to diagnose candidal cardiac infection in all patients b y transthoracic echocardiography, transoesophageal echo cardiography was us eful for optimal assessment of the valvar and paravalvar structures. Conclusions-In the setting of endocarditis, the detection of myocardial inv olvement, which is characterised by a heterogeneous myocardial texture, is an argument in favour of Candida species endocarditis and may warrant early surgical intervention.