The role of valve replacement in the treatment of fungal endocarditis.

The role of valve replacement in the treatment of fungal endocarditis has not been defined. The diagnosis of fungal endocarditis was made in 11 patients, 8 before death and 3 at autopsy. Nine patients were infected with Candida species, one with Torulopsis glabrada and one with Aspergillus. None of the 8 patients whose disease was diagnosed during life was cured despite up to 160 days of amphotericin B therapy. All required valve replacement for heart failure (1 patient), emboli (1 patient, or both (6 patients). We recommend early valve replacement for fungal endocarditis before the onset of heart failure and emboli.