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Caspofungin irrigation through percutaneous calicostomy catheter combined with oral flucytosine to treat fluconazole-resistant symptomatic candiduria
- Source :
- Journal of Medical Mycology = Journal de Mycologie Médicale, Journal of Medical Mycology = Journal de Mycologie Médicale, 2015, 25 (1), pp.87-90. ⟨10.1016/j.mycmed.2014.12.003⟩
- Publication Year :
- 2015
- Publisher :
- HAL CCSD, 2015.
-
Abstract
- Candiduria may be a marker of serious fungal infections such as pyelonephritis. With the exception of fluconazole and flucytosine, antifungals drugs are not excreted into the urine as active drugs, making the management of infection due to fluconazole-resistant Candida difficult. We report a case of recurrent Candida parapsilosis candiduria in a kidney transplant recipient suffering from chronic ureteral obstruction requiring permanent ureteral catheterization (double-J stent). Attempts to remove the stent led to pyelonephritis episodes during which only Candida was isolated from the urine. Following several courses of azole-based therapy, the causative agent became resistant to fluconazole. Clinical and mycological cure were obtained combining irrigations of caspofungin through a percutaneous calicostomy catheter and oral flucytosine. This strategy may represent an interesting therapeutic alternative in case of fluconazole-resistant symptomatic candiduria.
- Subjects :
- Adult
Male
medicine.medical_specialty
Percutaneous
Antifungal Agents
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
Administration, Oral
Flucytosine
Candida parapsilosis
Kidney Calices
chemistry.chemical_compound
Echinocandins
Lipopeptides
Pharmacotherapy
Caspofungin
Drug Resistance, Fungal
medicine
Humans
Candidiasis, Invasive
Therapeutic Irrigation
Fluconazole
biology
business.industry
Stent
biology.organism_classification
Combined Modality Therapy
Surgery
Catheter
Infectious Diseases
chemistry
Urinary Tract Infections
business
Urinary Catheterization
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 11565233 and 17730449
- Database :
- OpenAIRE
- Journal :
- Journal of Medical Mycology = Journal de Mycologie Médicale, Journal of Medical Mycology = Journal de Mycologie Médicale, 2015, 25 (1), pp.87-90. ⟨10.1016/j.mycmed.2014.12.003⟩
- Accession number :
- edsair.doi.dedup.....23dc13b9ad53af673f734fcbe8cb0637