Candida endocarditis: role of new antifungal agents

Mycoses. 2009 Jan;52(1):60-6. doi: 10.1111/j.1439-0507.2008.01533.x. Epub 2008 May 21.

Abstract

Despite the relative high frequency of Candida bloodstream infection, Candida endocarditis is a rare entity. We report seven cases, which occurred during a period of 1 year in western France. Six cases were because of Candida albicans, and one pacemaker endocarditis was because of Candida parapsilosis. All patients were men and presented risk factors for candidaemia. Of the six patients with valvular involvement, five received caspofungin and two had surgical valve replacement. Three patients treated with caspofungin antifungal therapy without valve replacement were cured from endocarditis. Antifungal and surgical strategies are discussed, in particular, the possible role of new antifungal therapies and long-term suppression therapy without surgery. One patient died in the acute phase of endocarditis, three patients died of causes unrelated to infective endocarditis and three patients had a favourable outcome.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / therapeutic use*
  • Candida / classification
  • Candida / isolation & purification*
  • Candidiasis / diagnosis*
  • Candidiasis / drug therapy*
  • Candidiasis / microbiology
  • Candidiasis / surgery
  • Caspofungin
  • Child
  • Child, Preschool
  • Echinocandins / therapeutic use
  • Endocarditis / drug therapy*
  • Endocarditis / microbiology*
  • Endocarditis / surgery
  • Fatal Outcome
  • Female
  • France
  • Heart Valve Diseases / drug therapy
  • Heart Valve Diseases / microbiology
  • Heart Valve Diseases / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Lipopeptides
  • Male
  • Middle Aged
  • Young Adult

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Caspofungin