Candida parapsilosis endocarditis: medical and surgical cure. Ann Intern Med

heart surgery (1), prolonged intravenous therapy (such as hyperalimentation, antibiotics), and heroin addiction (2). The commonest species has been Candida parapsilosis, in approximately 50 % of cases (3-5). Treatment with either antifungal agents or surgery alone has resulted in a poor survival rate (7 % to 14.5%), whereas combined medical and surgical therapy has had a more promising outlook (55 % to 80 % survival rate) (6). Adequate medical fol-low-up of treated survivors of Candida endocarditis has been poor (7, 8). We report a surviving patient who had proven Candida parapsilosis aortic valve endocarditis with surgically confirmed cure at 5l/2 years after medical and surgical intervention. A 30-year-old male former heroin addict was admitted to Columbia-Presbyterian Medical Center in March 1973 com-plaining of fatigue, muscle pains, dyspnea on exertion, orthop-nea, and a 20.4-kg weight loss. The physical examination showed a temperature of 38.8 °C; blood pressure, 120/30 mm Hg; and pulse, 130/min. Palmar petechiae, bilateral basila