Ultrastructure of Candida parapsilosis endocarditis

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Abstract
Light microscopy and scanning (SEM) and transmission electron microscopy (TEM) was used to study the structure of C. parapsilosis vegetations on 5 surgically removed porcine bioprosthetic values. SEM revealed a mossy amorphous surface. In some areas, C. parapsilosis cells could be seen below the surface layer. In areas in which the vegetation had cracked, myriads of healthy C. parapsilosis cells were seen to be loosely adherent to one another. These cells were covered with a flocculent or fibrillar matrix. A compact intercellular matrix was evident by TEM. Hyphal elements were seen invading valvular tissue. The loose matrix that bound large clumps of C. parapsilosis cells explains why large emboli are frequent complications of Candida endocarditis.