The Experts below are selected from a list of 225 Experts worldwide ranked by ideXlab platform
Emin Sami Arisoy - One of the best experts on this subject based on the ideXlab platform.
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PO-0175 Successful Treatment Of Fluconazole-resistant Candida Albicans Endocarditis With Caspofungin In An Infant Who Had A Pulmonary Artery Banding Procedure
Archives of Disease in Childhood, 2014Co-Authors: Murat Deveci, Özlem Kayabey, Zeynep Seda Uyan, Kadir Babaoğlu, Emin Sami ArisoyAbstract:Background and aims Despite the application of surgery and antifungal therapy, Candida Endocarditis remains a life-threatening infection with significant morbidity and mortality. We report an infant with floconazole-resistant Candida albicans Endocarditis who had a congenital heart defect and was treated successfully with caspofungin. Methods A 13-month-old girl was admitted to our centre with a 3-day history of vomiting, fever and cough. She had a history of pulmonary artery banding for a large ventricular septal defect at 4 months of age. After the operation she had been hospitalised about 3 months in the intensive care unit and had been discharged with tracheostomy and home ventilation due to chronic lung disease. At admission, she had irritability, dyspnea and a severe systolic murmur. Laboratory tests revealed an increase in acute-phase reactants and anaemia. Transthoracic echocardiography showed a vegetation measuring 7 × 10 mm on the wall of right pulmonary artery, just distal to the pulmonary banding region. Blood cultures were obtained and empiric antibiotic treatment with ampicillin/sulbactam and gentamicin was started. Results C. albicans was isolated from two of her blood culture samples, which was not responsive to one-week course of fluconazole treatment. The isolate was found to be resistant to fluconazole. Patient recovered completely with a six-week course of caspofungin treatment. Conclusions Physicians should be aware of the possibility of fungal pathogens in Endocarditis. Microbiologic diagnosis contributes to successful treatment of Candida Endocarditis.
Josip Begovac - One of the best experts on this subject based on the ideXlab platform.
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Candida albicans Endocarditis treatment with caspofungin in an hiv infected patient case report and review of literature
Journal of Infection, 2006Co-Authors: Valentina Bacak, Bojan Biocina, Sarah Gertler, Boris Starcevic, Josip BegovacAbstract:Caspofungin has recently been introduced for the treatment of invasive candidiasis, however, there is limited data on its use in Endocarditis. We report a 22-year-old male HIV-infected patient on methadone maintenance therapy that developed right-sided Candida albicans Endocarditis. Caspofungin treatment and vegetectomy, followed by fluconazole, was successful in the treatment of our patient. We also review all previous cases of Candida Endocarditis treated with caspofungin.
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Candida albicans Endocarditis treatment with caspofungin in an HIV-infected patient—case report and review of literature
The Journal of infection, 2005Co-Authors: Valentina Bacak, Bojan Biocina, Boris Starčević, Sarah Gertler, Josip BegovacAbstract:Caspofungin has recently been introduced for the treatment of invasive candidiasis, however, there is limited data on its use in Endocarditis. We report a 22-year-old male HIV-infected patient on methadone maintenance therapy that developed right-sided Candida albicans Endocarditis. Caspofungin treatment and vegetectomy, followed by fluconazole, was successful in the treatment of our patient. We also review all previous cases of Candida Endocarditis treated with caspofungin.
Wolfgang Graninger - One of the best experts on this subject based on the ideXlab platform.
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Prosthetic valve Endocarditis due to Candida tropicalis complicated by multiple pseudoaneurysms.
Infection, 2001Co-Authors: K. Zedtwitz-liebenstein, H. Gabriel, B. Willinger, H. Ehringer, P. Polterauer, Wolfgang GraningerAbstract:Candida Endocarditis is an unusual but severe complication caused by Candida albicans or other fungal species. We describe a case of prosthetic valve Endocarditis due to Candida tropicalis, complicated by multiple pseudoaneurysms.
Michael Z David - One of the best experts on this subject based on the ideXlab platform.
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Candida Infective Endocarditis: A Retrospective Study of Patient Characteristics and Risk Factors for Death in 703 United States Cases, 2015-2019.
Open forum infectious diseases, 2020Co-Authors: Jonathan P Huggins, Samuel F Hohmann, Michael Z DavidAbstract:Background Candida Endocarditis is a rare, sometimes fatal complication of candidemia. Past investigations of this condition are limited by small sample sizes. We used the Vizient clinical database to report on characteristics of patients with Candida Endocarditis and to examine risk factors for in-hospital mortality. Methods This was a multicenter, retrospective cohort study of 703 inpatients admitted to 179 US hospitals between October 2015 and April 2019. We reviewed demographic, diagnostic, medication administration, and procedural data from each patient's initial encounter. Univariate and multivariate logistic regression analyses were used to identify predictors of in-hospital mortality. Results Of 703 patients, 114 (16.2%) died during the index encounter. One hundred fifty-eight (22.5%) underwent an intervention on a cardiac valve. On multivariate analysis, acute and subacute liver failure was the strongest predictor of death (odds ratio [OR], 9.2; 95% confidence interval [CI], 4.8 -17.7). Female sex (OR, 1.9; 95% CI, 1.2-3.0), transfer from an outside medical facility (OR, 1.8; 95% CI, 1.1-2.8), aortic valve pathology (OR, 2.7; 95% CI, 1.5-4.9), hemodialysis (OR, 2.1; 95% CI, 1.1-4.0), cerebrovascular disease (OR, 2.2; 95% CI, 1.2-3.8), neutropenia (OR, 2.5; 95% CI, 1.3-4.8), and alcohol abuse (OR, 2.9; 95% CI, 1.3-6.7) were also associated with death on adjusted analysis, whereas opiate abuse was associated with a lower odds of death (OR, 0.5; 95% CI, 0.2-0.9). Conclusions We found that the inpatient mortality rate was 16.2% among patients with Candida Endocarditis. Acute and subacute liver failure was associated with a high risk of death, whereas opiate abuse was associated with a lower risk of death.
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1178. Risk factors for death among patients with Candida Endocarditis: An observational study in US academic medical centers
Open Forum Infectious Diseases, 2020Co-Authors: Jonathan Huggins, Michael Z David, Samuel F HohmannAbstract:Abstract Background Candida Endocarditis is a rare, sometimes fatal complication candidemia. Our understanding of this condition is limited to findings from case series and small observational studies. Using the Vizient clinical database, a repository for clinical and administrative data from 117 academic medical centers and more than 300 affiliated hospitals, we assembled the largest cohort of Candida Endocarditis patients to date, reporting patient characteristics and risk factors for death. Methods Using ICD-10 code B37.6 (Candidal Endocarditis) we identified 703 inpatients at 179 United States hospitals from October 2015 through April 2019. We examined demographic, diagnostic, and procedural data from each patient’s initial encounter. With univariate and multivariate logistic regression analyses we identified predictors of in-hospital mortality. Results Of 703 patients, 402 (57.2%) were male, 421 (59.9%) used tobacco, 213 (30.3%) had documented opiate abuse, 128 (18.2%) had other illicit drug abuse documented, and 190 (27.0%) had documented hepatitis C infection. Among the 703 patients, 114 (16.2%) died during the index encounter. On multivariate analysis, liver failure was the strongest predictor of death (OR 8.4, 95% CI 4.4 – 15.9), and female sex (OR 1.8, 95% CI 1.1 – 2.9), transfer from an outside facility (OR 1.7, 95% CI 1.1 – 2.7), underlying aortic valve pathology (OR 2.8, 95% CI 1.5 – 4.9), hemodialysis (OR 2.0, 95% CI 1.0 – 3.8), cerebrovascular disease (OR 2.2, 95% CI 1.2 – 3.8), neutropenia (OR 2.5, 95% CI 1.3 – 4.7) and alcohol abuse (OR 2.9, 95% CI 1.3 – 6.7) were also associated with higher odds of in-hospital death. In the same analysis, opiate abuse was associated with a lower odds of in-hospital death (OR 0.4, 95% CI 0.2 – 0.8). Table 1. Characteristics of 703 patients with Candida Endocarditis Table 2. Factors associated with in-hospital death in multivariate regression analysis Conclusion We found that for patients Candida Endocarditis inpatient mortality was 16.2% and liver failure was associated with a high risk of death while opiate abuse was protective. Further investigation is necessary to better understand these associations. Disclosures Michael Z. David, MD PhD, GSK (Consultant)
Murat Deveci - One of the best experts on this subject based on the ideXlab platform.
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PO-0175 Successful Treatment Of Fluconazole-resistant Candida Albicans Endocarditis With Caspofungin In An Infant Who Had A Pulmonary Artery Banding Procedure
Archives of Disease in Childhood, 2014Co-Authors: Murat Deveci, Özlem Kayabey, Zeynep Seda Uyan, Kadir Babaoğlu, Emin Sami ArisoyAbstract:Background and aims Despite the application of surgery and antifungal therapy, Candida Endocarditis remains a life-threatening infection with significant morbidity and mortality. We report an infant with floconazole-resistant Candida albicans Endocarditis who had a congenital heart defect and was treated successfully with caspofungin. Methods A 13-month-old girl was admitted to our centre with a 3-day history of vomiting, fever and cough. She had a history of pulmonary artery banding for a large ventricular septal defect at 4 months of age. After the operation she had been hospitalised about 3 months in the intensive care unit and had been discharged with tracheostomy and home ventilation due to chronic lung disease. At admission, she had irritability, dyspnea and a severe systolic murmur. Laboratory tests revealed an increase in acute-phase reactants and anaemia. Transthoracic echocardiography showed a vegetation measuring 7 × 10 mm on the wall of right pulmonary artery, just distal to the pulmonary banding region. Blood cultures were obtained and empiric antibiotic treatment with ampicillin/sulbactam and gentamicin was started. Results C. albicans was isolated from two of her blood culture samples, which was not responsive to one-week course of fluconazole treatment. The isolate was found to be resistant to fluconazole. Patient recovered completely with a six-week course of caspofungin treatment. Conclusions Physicians should be aware of the possibility of fungal pathogens in Endocarditis. Microbiologic diagnosis contributes to successful treatment of Candida Endocarditis.
