title: Successful treatment of recurrent candidemia due to candidal thrombophlebitis associated with a central venous catheter using a combination of fosfluconazole and micafungin.
abstract: We herein report the case of an 85-year-old woman presenting with right internal jugular vein candidal thrombophlebitis associated with central venous catheters (CTCVC). The infecting agent was Candida albicans, which caused recurrent candidemia five times in total. Micafungin (MCFG) alone was ineffective; however, the combination of MCFG with fosfluconazole (F-FLCZ) successfully treated the patient without a need for any anticoagulant or surgical therapies. To the extent of our knowledge, this is the first report of CTCVC being successfully treated with a combination of F-FLCZ and MCFG. These new antifungal agents have better efficacy, tolerability and bioavailability; therefore, they can be useful alternatives to classical combination therapies such as amphotericin-B and 5-fluorocytosine.
authors.affiliation: Emergency Unit and Critical Care Center, Tsuyama Central Hospital, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Hagiya
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kajioka
mesh_terms: D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage*; D058387:Candidemia / Q000188:drug therapy* / Q000209:etiology; D055499:Catheter-Related Infections / Q000188:drug therapy* / Q000209:etiology; D062905:Central Venous Catheters / Q000009:adverse effects; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000008:administration & dosage*; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D055666:Lipopeptides / Q000008:administration & dosage*; D000077551:Micafungin; D010755:Organophosphates / Q000008:administration & dosage*; D012008:Recurrence; D013924:Thrombophlebitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010755:Organophosphates; C486878:fosfluconazole; D015725:Fluconazole; D000077551:Micafungin