Development of candidemia on caspofungin therapy: a case report

Infection. 2006 Dec;34(6):345-8. doi: 10.1007/s15010-006-5613-7.

Abstract

Caspofungin, an echinocandin, is approved for use in invasive candidiasis. Few cases of break-through candidal infections during caspofungin therapy have been reported and none have involved Candida parapsilosis. Here, we report a patient who developed multiple post-operative complications after pancreaticoduodenectomy for a pancreatic mass, including fungemia due to C. parapsilosis, while on caspofungin for treatment of Candida glabrata peritonitis. The fungemia resolved after a central venous catheter was removed and therapy was switched from caspofungin to amphotericin B lipid complex. Studies of C. parapsilosis susceptibility and the pharmacodynamics and drug interactions of caspofungin that may contribute to breakthrough fungemia are discussed.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amphotericin B / therapeutic use*
  • Antibiotic Prophylaxis
  • Antifungal Agents / therapeutic use*
  • Candida glabrata / drug effects
  • Candidiasis / blood*
  • Candidiasis / drug therapy
  • Caspofungin
  • Catheters, Indwelling / microbiology
  • Cross Infection / blood
  • Cross Infection / drug therapy
  • Cross Infection / prevention & control
  • Drug Combinations
  • Drug Resistance, Fungal*
  • Echinocandins
  • Fungemia / drug therapy*
  • Humans
  • Lipopeptides
  • Male
  • Pancreaticoduodenectomy
  • Peptides, Cyclic / therapeutic use*
  • Phosphatidylcholines / therapeutic use*
  • Phosphatidylglycerols / therapeutic use*
  • Postoperative Complications

Substances

  • Antifungal Agents
  • Drug Combinations
  • Echinocandins
  • Lipopeptides
  • Peptides, Cyclic
  • Phosphatidylcholines
  • Phosphatidylglycerols
  • liposomal amphotericin B
  • Amphotericin B
  • Caspofungin