title: A rare case of fungal endocarditis caused by Candida glabrata after completion of antibiotic therapy for Streptococcus endocarditis.
abstract: We present the rare case of a 76-year-old female with infective endocarditis (IE) caused by Candida glabrata. Immediately before developing the present infection, she developed IE with vegetation on the mitral annular calcification, which was caused by Streptococcus mitis and successfully treated with penicillin-G and gentamicin. However, her fever recurred, and she developed disseminated intravascular coagulation. Blood culture revealed C. glabrata, and echocardiography revealed new vegetation on the mitral valve. After 4 weeks of treatment with micafungin, prosthetic valve replacement was performed, followed by additional administration of micafungin for 4 weeks (total of 8 weeks). No relapse at 9 months after surgery has been observed. C. glabrata endocarditis is extremely rare and difficult to manage. Our case and review of past reported cases suggest that early diagnosis and initiation of treatment contribute to good prognosis of C. glabrata endocarditis.
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan. tsugu917@gmail.com.|Department of Cardiology, Hino Municipal Hospital, 4-3-1, Tamadaira, Hino, Tokyo, 191-0062, Japan. tsugu917@gmail.com.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Tsugu
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Murata
authors.affiliation: Department of Cardiology, Saitama International Medical Center, Saitama, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Iwanaga
authors.affiliation: Department of Neurosurgery, Hino Municipal Hospital, Tokyo, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kitamura
authors.affiliation: Department of Cardiology, Hino Municipal Hospital, 4-3-1, Tamadaira, Hino, Tokyo, 191-0062, Japan.
authors.forename: Soushin
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D041221:Candida glabrata; D002177:Candidiasis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D042241:Early Diagnosis; D054714:Echinocandins / Q000627:therapeutic use; D004452:Echocardiography; D004698:Endocarditis, Subacute Bacterial / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006350:Heart Valve Prosthesis; D006801:Humans; D055666:Lipopeptides / Q000627:therapeutic use; D000077551:Micafungin; D010400:Penicillin G / Q000627:therapeutic use; D034361:Streptococcus mitis
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D054714:Echinocandins; D005839:Gentamicins; D055666:Lipopeptides; D010400:Penicillin G; D000077551:Micafungin
keywords: Candida glabrata; Echocardiography; Fungal endocarditis; Micafungin; Mitral valve replacement