Pulmonary hypertension due to recurrent pulmonary embolism from Candida albicans endocarditis of the tricuspid valve

We describe a case in which a previously unreported complication, due to recurrent embolism from right side mycotic endocarditis, occurred. A 36-year-old man developed Candida albicans endocarditis of the tricuspid valve after a troubled surgical history and a prolonged star in the Intensive Care Unit with a central indwelling catheter, Because valve replacement was judged to be unacceptably hazardous, the patient received only medical treatment. Recurrent septic embolism into the pulmonary circulation produced severe secondary hypertension. Five years after the diagnosis of Candida endocarditis the patient is still alive without signs of recurrent mycotic endocarditis; he is complaining of exertion dyspnoea and haemoptysis due to the severe pulmonary hypertension. Because the prognosis of severe pulmonary hypertension is very poor, it is important to be aware of this complication in the management of patients with Candida endocarditis involving the right side of the heart.