Treatment of Candida Glabrata With Micafungin: A Case Report and Brief Review of the Literature

Abstract

We report the case of a patient with multiple Candida bloodstream infections post emergency laparotomy, Hartmann’s procedure, abdominal closure and drainage. The patient also experienced recurrent central venous catheter Candida infections. The treatment of Candida tropicalis bloodstream infection with fluconazole and caspofungin was initially successful; however the patient consequently developed Candida glabrata bloodstream infection which did not respond to therapy with fluconazole or caspofungin. Although at the time of treatment of this patient, the C. glabrata strain was considered to be susceptible to caspofungin, the new clinical breakpoints recently published by the Clinical and Laboratory Standards Institute show that this strain was in fact resistant to caspofungin. The patient was successfully treated with micafungin and a line lock was used for the Hickman line. This case study is the first documented European case report of successful treatment of breakthrough C. glabrata blood stream infection with micafungin. J Med Cases. 2013;4(6):393-397 doi: https://doi.org/10.4021/jmc1237w