Echocardiographic features of Candida species endocarditis: 12 cases and a review of published reports.

OBJECTIVE

To describe the specific echocardiographic features of Candida species 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 year period were studied.

DESIGN

12 patients with confirmed Candida species endocarditis infection were identified. The transthoracic (n = 12) and transoesophageal (n = 12) echocardiographic 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 12 patients, was associated with extensive myocardial damage at surgery. While it was possible to diagnose candidal cardiac infection in all patients by transthoracic echocardiography, transoesophageal echocardiography was useful for optimal assessment of the valvar and paravalvar structures.

CONCLUSIONS

In the setting of endocarditis, the detection of myocardial involvement, which is characterised by a heterogeneous myocardial texture, is an argument in favour of Candida species endocarditis and may warrant early surgical intervention.