Amphotericin B Induction with Voriconazole Consolidation as Salvage Therapy for FKS -Associated Echinocandin Resistance in Candida glabrata Septic Arthritis and Osteomyelitis.

Authors :: Wright WF
Bejou N
Shields RK
Marr K
McCarty TP
Pappas PG
Source :: Antimicrobial agents and chemotherapy [Antimicrob Agents Chemother] 2019 Jul 25; Vol. 63 (8). Date of Electronic Publication: 2019 Jul 25 (Print Publication: 2019).
Publication Year :: 2019
Abstract: We report the case of a 61-year-old female with Crohn's disease dependent on total parenteral nutrition who developed a central venous catheter bloodstream infection and septic arthritis, complicated further by osteomyelitis and persistent Candida glabrata fungemia. Fluconazole treatment led to persistent infection, and micafungin therapy failed with development of FKS -associated resistance. Infection responded after initiation of amphotericin B plus voriconazole. Echinocandin resistance is increasingly recognized, suggesting a role for alternative antifungal therapies.<br /> (Copyright © 2019 American Society for Microbiology.)

Subjects :: Antifungal Agents therapeutic use
Arthritis, Infectious microbiology
Candida glabrata metabolism
Candidiasis drug therapy
Candidiasis microbiology
Fungal Proteins metabolism
Humans
Middle Aged
Osteomyelitis microbiology
Salvage Therapy methods
Amphotericin B therapeutic use
Arthritis, Infectious drug therapy
Candida glabrata drug effects
Drug Resistance, Fungal drug effects
Echinocandins therapeutic use
Osteomyelitis drug therapy
Voriconazole therapeutic use

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