Fungal endocarditis following cardiac surgery.

This study analysed cases of fungal endocarditis following cardiac surgery encountered in our institute between January 1994 and December 1997. A total of 887 prosthetic valve and 114 homograft valve replacements were performed during the study period. In this group, eight cases of fungal endocarditis (aged 14-53 years) were encountered during the follow-up of which five were caused by candida species and three by aspergillus species. Four cases involved aortic homografts, two mitral prosthesis, one an aortic prosthesis and one was a Goretex patch endocarditis. Seven patients had early endocarditis; all presented with fever and two had embolic manifestations. Seven patients each had positive blood cultures and echocardiographically demonstrable vegetations. Despite management with amphotericin B and early repeat surgical interventions, six had a fatal outcome. One patient is doing well at nine months follow-up after a second valve replacement and one is lost to follow-up.