title: Candidemia in children after complex congenital heart defects surgery treated with caspofungin--our own experience and a review of literature.
abstract: BACKGROUND
  Invasive fungal infections due to Candida species constitute an increasing clinical problem. There are no guidelines for the management of candidemia in children undergoing surgical procedures for congenital heart defects (CHD). The aim of the study was to draw attention to the problem of candidemia in children who are operated on due to congenital heart defects.
  
  
  METHODS
  We retrospectively analyzed medical documentation of 307 children with congenital heart defects treated in 1 clinical centre in Poland, from whom we selected those diagnosed with candidemia during the postoperative period. Next, we analyzed in detail the clinical course of invasive candidiasis in each individual and we performed an analysis of risk factors that lead to candidemia.
  
  
  RESULTS
  In the analyzed period, among 307 children who underwent surgical procedures, we observed 2 cases of candidemia (0.65%) which were effectively cured with caspofungin. No adverse effects were observed after treatment with the drug.
  
  
  CONCLUSIONS
  Candidemia in children who undergo surgical treatment of congenital heart defects is an important factor that can influence final clinical results. Caspofungin may be an effective therapeutic option when treating candidemia in children after extensive cardiosurgical procedures.
authors.affiliation: Department of Pediatric Cardiac Surgery, Mikołaj Kopernik Pomeranian Centre of Traumatology, Gdansk, Poland. radicis@go2.pl
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Jaworski
authors.forename: Ninela
authors.initials: N
authors.lastname: Irga
authors.forename: Ireneusz
authors.initials: I
authors.lastname: Haponiuk
authors.forename: Maciej
authors.initials: M
authors.lastname: Chojnicki
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Arlukowicz
authors.forename: Mariusz
authors.initials: M
authors.lastname: Steffek
authors.forename: Mariusz
authors.initials: M
authors.lastname: Sroka
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Gierat-Haponiuk
authors.forename: Jacek
authors.initials: J
authors.lastname: Juscinski
authors.forename: Lucyna
authors.initials: L
authors.lastname: Palkowska
authors.forename: Aneta
authors.initials: A
authors.lastname: Sendrowska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kosiak
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D058387:Candidemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D000077336:Caspofungin; D002648:Child; D054714:Echinocandins / Q000627:therapeutic use*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D055666:Lipopeptides
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D002097:C-Reactive Protein; D000077336:Caspofungin