Although Candida can be isolated from the throats of approximately 25% of normal adults1,2 and from the sputa2,3 of approximately 50%, it causes infection relatively infrequently. The most common manifestations of candidiasis in adults are seen in the oral and vaginal mucosae and the skin, and are often related to diabetes, debilitated states, and pregnancy. The use of broadspectrum antibiotics is now well established as a cause for increased growth of Candida in the gastrointestinal tract, particularly its lower portion,2 and has accordingly been incriminated in the increased frequency of Candida infections. Disseminated candidiasis, nevertheless, remains an uncommon disease in adults, and documented involvement of the endocardium by Candida has been rare.
Because all common systemic mycoses are caused by agents that lose their mycelial form in vivo,4 the low invasiveness of Candida albicans has been attributed to its transformation to the nonpathogenic mycelial form in
HEINEMAN HS, YUNIS EJ, SIEMIENSKI J, BRAUDE AI. Chlamydospores and Dimorphism in Candida Albicans EndocarditisObservations in a Fatal Superinfection During Treatment of Staphylococcus Endocarditis. Arch Intern Med. 1961;108(4):570-577. doi:10.1001/archinte.1961.03620100062008