Native valve endocarditis due to Candida glabrata treated without valvular replacement: a potential role for caspofungin in the induction and maintenance treatment.
Conventional antifungal therapy for fungal endocarditis has been associated with a poor cure rate. Therefore, combined medical and surgical therapy has been recommended. However, new potent antifungal agents, such as echinocandins, could increase the medical options and, in some cases, avoid the need for surgery. We report a case of Candida endocarditis treated successfully without valve replacement with intravenous liposomal amphotericin B (total dose, 4 g) and intravenous caspofungin (a 100-mg loading dose followed by 50 mg per day for 8 weeks) as induction therapy and intravenous caspofungin (100 mg 3 times per week for 12 weeks) as maintenance therapy.
Institut d'Investigacions Biomediques August Pi i Sunyer-Hospital Clinic, University of Barcelona, Barcelona, Spain.
M J
MJ
Jiménez-Expósito
G
G
Torres
A
A
Baraldés
N
N
Benito
F
F
Marco
J C
JC
Paré
A
A
Moreno
X
X
Claramonte
C A
CA
Mestres
M
M
Almela
C
C
García de la María
N
N
Pérez
W A
WA
Schell
G R
GR
Corey
J
J
Perfect
M T
MT
Jiménez de Anta
J M
JM
Gatell
J M
JM
Miró
D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D041221:Candida glabrata; D002177:Candidiasis / Q000175:diagnosis* / Q000382:microbiology; D000077336:Caspofungin; D004359:Drug Therapy, Combination; D054714:Echinocandins; D004696:Endocarditis / Q000188:drug therapy* / Q000382:microbiology*; D005260:Female; D006801:Humans; D055666:Lipopeptides; D010456:Peptides, Cyclic / Q000627:therapeutic use*
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D000666:Amphotericin B; D000077336:Caspofungin