Fungal Endocarditis: Review of Our Cases over a Four-Year Period

Over a 4-year period, we studied six cases of fungal endocarditis, four of which were caused by Aspergillus sp. and the other two were candidal in origin. Both sides of the heart showed involvement by these infections. The vegetations of infective endocarditis tend to vary in size, but fungal lesions are often large. Our youngest patient was four months old and the oldest one was 62 years old. A high index of clinical suspicion, together with histopathological and microbiological studies, can be used as tools to diagnose and treat such patients in due course. It is important to send fresh specimens for tissue culture studies in sterile normal saline and not in fixatives such as formaldehyde. Pathologically, not only are the special staining methods such as Periodic acid-Schiff useful in the demonstration of fungal elements in tissue or vegetation sections, but also the routine hematoxylin and eosin stain is capable of showing these structures clearly.