[A case report of acute pulmonary valve endocarditis caused by fungi]

A 42 years old female was admitted for evaluation of unrelenting fever and dyspnea on exertion in March, 1991. The patient had a VSD closure in 1968. After admission, serial blood cultures were found to be positive for Candida Parapsilosis and a massive vegetation on the pulmonary valve was demonstrated by echocardiography. Chest X-ray disclosed a wedge-shaped density in the right middle lung lobe that was a compatible finding with pulmonary infarction. At surgery, performed 3 days later the admission, pulmonary valve was entirely resected without replacing it with prosthesis. Antifungal treatment was intensively given afterwards. Her postoperative course was without event and she was sent home on the 51st postoperative day. Right heart catheterization done two years surgery, revealed the pulmonary vascular resistance was 216 dynes sec cm-5. We anticipate that this degree of pulmonary vascular resistance will allow the patient enough to do well without needing valve prosthesis in the near future.