A rare case of fungal endocarditis caused by Candida glabrata after completion of antibiotic therapy for Streptococcus endocarditis

J Med Ultrason (2001). 2015 Apr;42(2):243-6. doi: 10.1007/s10396-014-0580-6. Epub 2014 Oct 15.

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.

Keywords: Candida glabrata; Echocardiography; Fungal endocarditis; Micafungin; Mitral valve replacement.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • Candida glabrata*
  • Candidiasis / blood
  • Candidiasis / diagnostic imaging
  • Candidiasis / etiology*
  • Candidiasis / therapy
  • Early Diagnosis
  • Echinocandins / therapeutic use
  • Echocardiography
  • Endocarditis, Subacute Bacterial / complications*
  • Endocarditis, Subacute Bacterial / diagnostic imaging
  • Endocarditis, Subacute Bacterial / drug therapy*
  • Female
  • Gentamicins / therapeutic use
  • Heart Valve Prosthesis
  • Humans
  • Lipopeptides / therapeutic use
  • Micafungin
  • Penicillin G / therapeutic use
  • Streptococcus mitis*

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents
  • Echinocandins
  • Gentamicins
  • Lipopeptides
  • Penicillin G
  • Micafungin