title: Successful treatment of liposomal amphotericin B refractory Candida glabrata fungaemia in a patient undergoing a stem cell transplantation.
abstract: Blood stream infections caused by Candida glabrata are difficult to manage. We describe a patient who underwent an allogeneic peripheral stem cell transplantation for acute myeloid leukaemia. The patient developed C. glabrata fungaemia that was refractory to liposomal amphotericin B therapy. After changing the therapy to caspofungin, blood cultures became sterile within two days and the patient recovered clinically. The patient died shortly after due to graft-versus-host disease and at autopsy there was no evidence of residual or persistent Candida infection. Caspofungin was effective in liposomal amphotericin-B refractory C. glabrata fungaemia and proved to rapidly clear the infection. Treatment options for candidaemia are discussed.
authors.affiliation: Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. b.veldman@aig.umcn.nl
authors.forename: B A J
authors.initials: BA
authors.lastname: Veldman
authors.forename: P E
authors.initials: PE
authors.lastname: Verweij
authors.forename: N M A
authors.initials: NM
authors.lastname: Blijlevens
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D041221:Candida glabrata / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology; D000077336:Caspofungin; D054714:Echinocandins; D005260:Female; D006801:Humans; D055666:Lipopeptides; D008081:Liposomes; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000494:pharmacology / Q000627:therapeutic use*; D033581:Stem Cell Transplantation; D017211:Treatment Failure
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D008081:Liposomes; D010456:Peptides, Cyclic; D000666:Amphotericin B; D000077336:Caspofungin