1/9. Caspofungin in a pediatric patient with persistent candidemia.OBJECTIVE: To describe the response of a child with persistent fungemia to caspofungin, a member of the echinocandin class of antifungals. DESIGN: Descriptive case report. SETTING: Pediatric intensive care unit at a university teaching hospital. PATIENT: A 3-yr-old female with persistent candidemia. INTERVENTION: After >5 wks of persistent candidemia, caspofungin was added to an antifungal regimen that included amphotericin b and flucytosine. MEASUREMENTS AND MAIN RESULTS: The addition of caspofungin resulted in rapid clearance of the candidemia. The child recovered without evidence of further fungal infection or overt toxicity. CONCLUSION: Caspofungin was administered safely in this pediatric patient and possibly contributed to her clinical improvement. Caspofungin may be considered in children with severe persistent fungal infections that are not responsive to standard therapy. More study in pediatric patients is necessary before recommending its general use.- - - - - - - - - - ranking = 1keywords = candidemia (Clic here for more details about this article) |
2/9. Late onset Candida parapsilosis endocarditis after surviving nosocomial candidemia in an infant with structural heart disease.The incidence of nosocomial candidemia is increasing. Late onset endocarditis after surviving nosocomial fungemia is described in adults. We report a case of late onset Candida parapsilosis endocarditis of a structurally abnormal aortic valve in an infant surviving nosocomial candidemia.- - - - - - - - - - ranking = 0.85714285714286keywords = candidemia (Clic here for more details about this article) |
3/9. survival of candida sepsis in extracorporeal membrane oxygenation.OBJECTIVE: To report the survival of fungal sepsis in extracorporeal membrane oxygenation. DESIGN: Single case report. SETTING: Tertiary referral children's hospital pediatric intensive care unit. patients: A single case report of an infant with congenital heart disease who developed candida sepsis while supported postoperatively with extracorporeal membrane oxygenation. RESULTS: This infant survived a prolonged episode of candidemia after repair of congenital heart disease, which required extracorporeal membrane oxygenation support. The patient has no identified sequelae at 6-month follow-up and continues on long-term fluconazole therapy for candida endocarditis. CONCLUSIONS: candidemia, particularly candida albicans species, may not be a contraindication for extracorporeal membrane oxygenation support. With antifungal therapy and adequate inotropic use to counter the effects of septicemia, survival can be maintained until the patient adequately recovers, allowing decannulation, removal of all catheters, and eventual bloodstream sterility.- - - - - - - - - - ranking = 0.14285714285714keywords = candidemia (Clic here for more details about this article) |
4/9. Late recurrent Candida endocarditis.Late recurrent Candida endocarditis (LRCE) developed on a prosthetic mitral valve 22 months after treatment for primary native mitral valve endocarditis. The LRCE was difficult to diagnose; results of two dimensional echocardiography and repeated blood cultures were negative. Only transesophageal echocardiography revealed a vegetation and only lysis centrifugation blood cultures demonstrated candidemia. Postmortem examination revealed a large Candida vegetation on the prosthetic valve and Candida in the mitral valve ring. This case and a review of the literature indicate that Candida endocarditis treated with amphotericin b and prosthetic valve replacement may recur months after treatment, and that LRCE, which is difficult to diagnose and treat, may be best prevented by lifelong antifungal suppressive therapy.- - - - - - - - - - ranking = 0.14285714285714keywords = candidemia (Clic here for more details about this article) |
5/9. Candida right ventricular mural endocarditis complicating indwelling right atrial catheter.Catheter-associated candidemia is a common problem in immunocompromised patients. A leukemic patient had Candida right ventricular mural endocarditis complicating an indwelling right atrial catheter. To our knowledge, this is the first reported case of Candida right ventricular mural vegetation visualized by two-dimensional echocardiography.- - - - - - - - - - ranking = 0.14285714285714keywords = candidemia (Clic here for more details about this article) |
6/9. rupture of a pulmonary artery mycotic aneurysm associated with candidal endocarditis.Candidal endocarditis can develop if candidemia occurs during Swan-Ganz catheterization. Candida endocarditis may persist for many months and is fatal unless the infected valve is resected. Herein is reported the first case of rupture of a mycotic pulmonary artery aneurysm caused by chronic candidal endocarditis. The endocarditis followed Swan-Ganz catheterization and aneurysm progressed despite appropriate medical and surgical therapy.- - - - - - - - - - ranking = 0.14285714285714keywords = candidemia (Clic here for more details about this article) |
7/9. Nosocomial candidemia: risk factors and attributable mortality.Over the past decade, the incidence of hospital-acquired bloodstream infections caused by Candida species has risen and the species associated with such infections have changed. The incidence of candidemia is dramatically higher in high-risk, critical-care units than in other parts of the hospital. Certain underlying physical conditions including acute leukemia, leukopenia, burns, gastrointestinal disease, and premature birth predispose patients to nosocomial candidemia. Independent risk factors include prior treatment with multiple antibiotics, prior Hickman catheterization, isolation of Candida species from sites other than the blood, and prior hemodialysis. In this article some of the challenges posed by the management of nosocomial candidemia are presented in three case studies. In addition, the results of several investigations of nosocomial candidemia at the University of iowa hospitals and Clinics are reviewed.- - - - - - - - - - ranking = 1.1428571428571keywords = candidemia (Clic here for more details about this article) |
8/9. Medical treatment of recurrent candidemia in a patient with probable Candida parapsilosis prosthetic valve endocarditis.Fungal endocarditis is considered an absolute indication for valve replacement surgery. We describe the successful medical treatment of recurrent Candida parapsilosis candidemia with sequential treatment with amphotericin b and fluconazole in a patient with probable prosthetic valve endocarditis. Because of the presumed effectiveness of amphotericin b and fluconazole in the treatment of this patient, medical therapy should be considered as potentially useful in the treatment of recurrent C parapsilosis fungemia or endocarditis or both.- - - - - - - - - - ranking = 0.71428571428571keywords = candidemia (Clic here for more details about this article) |
9/9. Native valve endocarditis due to Candida parapsilosis: a late complication after bone marrow transplantation-related fungemia.A case of Candida parapsilosis endocarditis observed 16 months after BMT is reported. The patient, a 35-year-old female with CML, suffered from Candida parapsilosis fungemia on day 22 after BMT. In spite of treatment with amphotericin b, fluconazole and catheter withdrawal, the same yeast was isolated > 1 year later from a vegetation on an old rheumatic mitral valve. Although the patient remained in complete cytogenetical and hematological remission, in vitro tests showed reduced phagocytic and chemotactic capacity of neutrophils and monocytes. This case stresses the need of prolonged therapy for patients with candidemia after BMT.- - - - - - - - - - ranking = 0.14285714285714keywords = candidemia (Clic here for more details about this article) |