Fungi account for about 1% of all cases of infective endocarditis. Two-thirds of cases of fungal endocarditis are due to Candida, and one-third are due to Aspergillus species.
This is a case report of a 36-year-old male, a known case of rheumatic valvular heart disease of the native aortic and mitral valves.  Two years after the replacement of the aortic and mitral valves with prosthetic valves, he developed two consecutive episodes of prosthetic valve endocarditis. The results of sputum and blood cultures were negative and Elisa test was non-reactive. This patient was a healthy male without risk factors for immunodeficiency state and without a history of consumption of immunosuppressive drugs. This case emphasizes the need to regard fungal infection as a cause of prosthetic heart valve endocarditis even in healthy patients for early diagnosis and treatment