Survival after rupture of the oesophagus and subsequent candidal endocarditis: use of new serological methods in management.

The prognosis following both spontaneous rupture of the oesophagus (Boerhaave's syndrome) and candidal endocarditis is poor. Antifungal treatment for the latter has, in the past, been empirical. A patient who survived both these conditions is described, his case demonstrating some of the major risk factors for candidal endocarditis. Management of his antifungal treatment was guided by newly developed serological methods. Close liaison between microbiologist and clinician is essential for the management of this serious condition.