OBJECTIVE To describe the specific echocardiographic features of Candidaspecies endocarditis.

DESIGN Retrospective review of the case records of patients with confirmed candida endocarditis.

SETTING Cases referred to three French university centres over an eight year period were studied.

DESIGN 12 patients with confirmedCandida species endocarditis infection were identified. The transthoracic (n = 12) and transoesophageal (n = 12) echocardiographic appearances were compared with the surgical findings (n = 10).

RESULTS Large dense heterogeneous vegetations were found in 11/12 cases. A hyperechogenic heterogeneous myocardial texture, observed in seven of the 12 patients, was associated with extensive myocardial damage at surgery. While it was possible to diagnose candidal cardiac infection in all patients by transthoracic echocardiography, transoesophageal echocardiography was useful for optimal assessment of the valvar and paravalvar structures.

CONCLUSIONS In the setting of endocarditis, the detection of myocardial involvement, which is characterised by a heterogeneous myocardial texture, is an argument in favour of Candida species endocarditis and may warrant early surgical intervention.