Candida Endocarditis in Two Patients

Candida endocarditis was first described in 1939 by Freedman and Donaldson as an unidentified yeast on the aortic valve. Since then, numerous reports have been published. No effective treatment was available before the introduction of amphotericin B, although Harrell and Thompson did report successful treatment with nystatin in one case. 1 The following cases prompted us to review the literature regarding the management of this disease. PATIENT SUMMARIES Patient 1.— A 17-year-old male heroin user entered the Martland Hospital in May 1973, with a two-week history of increasing shortness of breath, anorexia, and vomiting. Fever with chills supervened five days prior to admission. He had experienced rheumatic fever at the age of seven years, and seven years later he was found to have mitral stenosis and incompetence. Three years before admission, the mitral valve was replaced by a Starr-Edwards prosthesis. Thereafter, the patient was unavailable for follow-up and did not