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Candida glabrata prosthetic valve endocarditis treated successfully with fluconazole plus caspofungin without surgery: a case report and literature review

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Abstract

Reported here is the case of a 72-year-old man who was diagnosed with Candida glabrata prosthetic mitral valve endocarditis and treated successfully with fluconazole plus caspofungin after he refused and was determined unfit for surgery. Initial treatment with intravenous amphotericin B resulted in acute renal impairment. Despite 8 days of intravenous fluconazole therapy, he remained fungemic. Caspofungin was added to the treatment regimen with subsequent sterilisation of blood culture. The patient was treated for 34 days with caspofungin and 41 days with fluconazole. He continued oral fluconazole after hospital discharge and remained well at follow-up 11 months later. The role of fluconazole and caspofungin in the treatment of Candida endocarditis is discussed.

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References

  1. Pappas PG, Rex JH, Sobel JD, et al. (2004) Guidelines for treatment of candidiasis. Clin Infect Dis 38:161–189

    Article  PubMed  Google Scholar 

  2. Groll AH, Kolve H (2004) Antifungal agents: in vitro susceptibility testing, pharmacodynamics, and prospects for combination therapy. Eur J Clin Microbiol Infect Dis 23:256–270

    Article  PubMed  CAS  Google Scholar 

  3. Ellis ME, Al-Abdely H, Sandridge A, Greer W, Ventura W (2001) Fungal endocarditis: evidence in the world literature, 1965–1995. Clin Infect Dis 32:50–62

    Article  PubMed  CAS  Google Scholar 

  4. Pierrotti LC, Baddour LM (2002) Fungal endocarditis, 1995–2000. Chest 122:302–310

    Article  PubMed  Google Scholar 

  5. Muehrcke DD, Lytle BW, Cosgrove III DM (1995) Surgical and long-term antifungal therapy for fungal prosthetic valve endocarditis. Ann Thorac Surg 60:538–543

    Article  PubMed  CAS  Google Scholar 

  6. Melgar GR, Nasser RM, Gordon SM, Lytle BW, Keys TF, Longworth DL (1997) Fungal prosthetic valve endocarditis in 16 patients: an 11-year experience in a tertiary care hospital. Medicine (Baltimore) 76:94–103

    Article  CAS  Google Scholar 

  7. Nguyen MH, Nguyen ML, Yu VL, McMahon D, Keys TF, Amidi M (1996) Candida prosthetic valve endocarditis: prospective study of six cases and review of the literature. Clin Infect Dis 22:262–267

    PubMed  CAS  Google Scholar 

  8. Kuhn DM, George T, Chandra J, Mukherjee PK, Ghannoum MA (2002) Antifungal susceptibility of Candida biofilms: unique efficacy of amphotericin B lipid formulations and echinocandins. Antimicrob Agents Chemother 46:1773–1780

    Article  PubMed  CAS  Google Scholar 

  9. Ramage G, VandeWalle K, Bachmann SP, Wickes BL, Lopez-Ribot JL (2002) In vitro pharmacodynamic properties of three antifungal agents against preformed Candida albicans biofilms determined by time-kill studies. Antimicrob Agents Chemother 46:3634–3636

    Article  PubMed  CAS  Google Scholar 

  10. Rubinstein E, Noriega ER, Simberkoff MS, Rahal JJ (1974) Tissue penetration of amphotericin B in Candida endocarditis. Chest 66:376–377

    Article  PubMed  CAS  Google Scholar 

  11. Czwerwiec FS, Bilsker MS, Kamerman ML, Bisno AL (1993) Long-term survival after fluconazole therapy of candidal prosthetic valve endocarditis. Am J Med 94:545–546

    Article  PubMed  CAS  Google Scholar 

  12. Longman LP, Hibbert SA, Martin MV (1990) Efficacy of fluconazole in prophylaxis and treatment of experimental Candida endocarditis. Rev Infect Dis 16:794–798

    Google Scholar 

  13. Pfaller MA, Diekema DJ, Messer SA, Hollis RJ, Jones RN (2003) In vitro activities of caspofungin compared with those of fluconazole and itraconazole against 3959 clinical isolates of Candida spp., including 157 fluconazole-resistant isolates. Antimicrob Agents Chemother 47:1068–1071

    Article  PubMed  CAS  Google Scholar 

  14. Pfaller MA, Messer SA, Boyken L, et al. (2003) Caspofungin activity against clinical isolates of fluconazole-resistant Candida. J Clin Microbiol 41:5729–5731

    Article  PubMed  CAS  Google Scholar 

  15. Mora-Duarte J, Betts R, Rotstein C, et al. (2002) Comparison of caspofungin and amphotericin B for invasive candidiasis. N Engl J Med 347:2020–2029

    Article  PubMed  CAS  Google Scholar 

  16. Mrowczynski W, Wojtalik M (2004) Caspofungin for Candida endocarditis. Pediatr Infect Dis J 23:376

    PubMed  Google Scholar 

  17. Jimenez-Exposito MJ, Torres G, Baraldes A, et al. (2004) Native valve endocarditis due to Candida glabrata treated without valvular replacement: a potential role for caspofungin in the induction and maintenance treatment. Clin Infect Dis 39:e70–73

    Article  PubMed  CAS  Google Scholar 

  18. Prabhu RM, Orenstein R (2004) Failure of caspofungin to treat brain abscesses secondary to Candida albicans prosthetic valve endocarditis. Clin Infect Dis 39:1253–1254

    Article  PubMed  Google Scholar 

  19. Deresinski SC, Stevens DA (2003) Caspofungin. Clin Infect Dis 36:1445–1457

    Article  PubMed  CAS  Google Scholar 

  20. Antoniadou A, Kontoyiannis DP (2003) Status of combination therapy for refractory mycoses. Curr Opin Infect Dis 16:539–545

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Infectious Diseases, Level 7, Geelong Hospital, Ryrie Street, PO Box 281, Geelong, 3220, Victoria, Australia

    D. C. B. Lye, A. Hughes, D. O'Brien & E. Athan

Authors
  1. D. C. B. Lye
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  2. A. Hughes
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  3. D. O'Brien
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  4. E. Athan
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Correspondence to E. Athan.

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Lye, D.C.B., Hughes, A., O'Brien, D. et al. Candida glabrata prosthetic valve endocarditis treated successfully with fluconazole plus caspofungin without surgery: a case report and literature review. Eur J Clin Microbiol Infect Dis 24, 753–755 (2005). https://doi.org/10.1007/s10096-005-0038-2

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  • DOI: https://doi.org/10.1007/s10096-005-0038-2

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