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.