Infect Chemother.  2012 Dec;44(6):499-503. 10.3947/ic.2012.44.6.499.

A Case of Candida pelliculosa Prosthetic Valve Endocarditis Treated with Anidulafungin and Valve Replacement

• Kang SJ
• Jang MO
• Jang HC
• Jung SI
• Shin JH
• Park KH

• KMID: 1806942
• DOI: http://doi.org/10.3947/ic.2012.44.6.499

Abstract

Candida pelliculosa is a rare cause of human infection. In this report, we describe a case of infective endocarditis caused by C. pelliculosa in a patient with a prosthetic heart valve. A 72-year-old female presented with a complaint of blurred vision, which she had been experiencing over a period of four weeks. Transthroasic echocardiography showed vegetation on the prosthetic mitral valve. A blood culture isolate was confirmed as C. pelliculosa.

Keyword

Candida pelliculosa; Anidulafungin; Infective endocarditis

MeSH Terms

Candida
Echinocandins
Echocardiography
Endocarditis
Female
Heart Valves
Humans
Mitral Valve
Vision, Ocular
Echinocandins

Figure

• 

  Figure 1 Transthoracic echocardiogram shows two large oscillating vegetations at the mechanical mitral valve (1.29×1.12 cm, 1.86×1.32 cm).

• 

  Figure 2 Computed tomographic angiography shows right axillary artery occlusion with patent distal runoff.

• 

  Figure 3 Hospital course of a with patient C. pelliculosa was isolated in atwo sets of blood. bone set of blood. cRedo MVR, Redo-mitral valve replacement.

Reference

1. Lefort A, Chartier L, Sendid B, Wolff M, Mainardi JL, Podglajen I, Desnos-Ollivier M, Fontanet A, Bretagne S, Lortholary O. French Mycosis Study Group. Diagnosis, management and outcome of Candida endocarditis. Clin Microbiol Infect. 2012. 18:E99–E109.

2. Douglas LJ. Candida biofilms and their role in infection. Trends Microbiol. 2003. 11:30–36.

3. Pappas PG, Kauffman CA, Andes D, Benjamin DK Jr, Calandra TF, Edwards JE Jr, Filler SG, Fisher JF, Kullberg BJ, Ostrosky-Zeichner L, Reboli AC, Rex JH, Walsh TJ, Sobel JD. Infectious Diseases Society of America. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009. 48:503–535.

4. Rubinstein E, Noriega ER, Simberkoff MS, Rahal JJ Jr. Tissue penetration of amphotericin B in Candida endocarditis. Chest. 1974. 66:376–377.

5. Chen SC, Slavin MA, Sorrell TC. Echinocandin antifungal drugs in fungal infections: a comparison. Drugs. 2011. 71:11–41.

6. Jiménez-Expósito MJ, Torres G, Baraldés A, Benito N, Marco F, Paré JC, Moreno A, Claramonte X, Mestres CA, Almela M, García de la María C, Pérez N, Schell WA, Corey GR, Perfect J, Jiménez de Anta MT, Gatell JM, Miró JM. Native valve endocarditis due to Candida glabrata treated without valvular replacement: a potential role for caspofungin in the induction and maintenance treatment. Clin Infect Dis. 2004. 39:e70–e73.

7. Lye DC, Hughes A, O'Brien D, Athan E. Candida glabrata prosthetic valve endocarditis treated successfully with fluconazole plus caspofungin without surgery: a case report and literature review. Eur J Clin Microbiol Infect Dis. 2005. 24:753–755.

8. De Rosa FG, D'Avolio A, Corcione S, Baietto L, Raviolo S, Centofanti P, Pasero D, Rinaldi M, Di Perri G. Anidulafungin for Candida glabrata infective endocarditis. Antimicrob Agents Chemother. 2012. 56:4552–4553.

9. Kalkanci A, Dizbay M, Turan O, Fidan I, Yalçin B, Hirfanoğlu I, Kuştimur S, Aktaş F, Sugita T. Nosocomial transmission of Candida pelliculosa fungemia in a pediatric intensive care unit and review of the literature. Turk J Pediatr. 2010. 52:42–49.

10. Luzzati R, Amalfitano G, Lazzarini L, Soldani F, Bellino S, Solbiati M, Danzi MC, Vento S, Todeschini G, Vivenza C, Concia E. Nosocomial candidemia in non-neutropenic patients at an Italian tertiary care hospital. Eur J Clin Microbiol Infect Dis. 2000. 19:602–607.

11. Nohinek B, Zee-Cheng CS, Barnes WG, Dall L, Gibbs HR. Infective endocarditis of a bicuspid aortic valve caused by Hansenula anomala. Am J Med. 1987. 82:165–168.

12. Kim MN, Shin JH, Sung H, Lee K, Kim EC, Ryoo N, Lee JS, Jung SI, Park KH, Kee SJ, Kim SH, Shin MG, Suh SP, Ryang DW. Candida haemulonii and closely related species at 5 university hospitals in Korea: identification, antifungal susceptibility, and clinical features. Clin Infect Dis. 2009. 48:e57–e61.

13. Versalovic J. Versalovic J, editor. Candida, Cryptococcus, and Other Yeasts. Manual of Clinical Microbiology. 2011. 10th ed. Washington DC: ASM press;1793–1821.

14. Wang CJ, Schwarz J. The etiology of interstitial pneumonia identification as Hansenula anomala of a yeast isolated from lungs of infants. Mycopathol Mycol Appl. 1958. 9:299–306.

15. Ratcliffe L, Davies J, Anson J, Hales S, Beeching NJ, Beadsworth MB. Candida pelliculosa meningitis as an opportunistic infection in HIV: the first reported case. Int J STD AIDS. 2011. 22:54–56.

16. Murphy N, Buchanan CR, Damjanovic V, Whitaker R, Hart CA, Cooke RW. Infection and colonisation of neonates by Hansenula anomala. Lancet. 1986. 1:291–293.

17. Qadri SM, Al Dayel F, Strampfer MJ, Cunha BA. Urinary tract infection caused by Hansenula anomala. Mycopathologia. 1988. 104:99–101.

18. Castanheira M, Woosley LN, Diekema DJ, Jones RN, Pfaller MA. Candida guilliermondii and other Species of Candida Misidentified as Candida famata: Assessment by the Vitek 2, DNA-sequencing Analysis, and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry in Two Global Antifungal Surveillance Programs. J Clin Microbiol. 2013. 51:117–124.

19. Choi SH, Chung JW. Time to positivity of follow-up blood cultures in patients with persistent Staphylococcus aureus bacteremia. Eur J Clin Microbiol Infect Dis. 2012. 31:2963–2967.

20. Fiori B, Posteraro B, Torelli R, Tumbarello M, Perlin DS, Fadda G, Sanguinetti M. In vitro activities of anidulafungin and other antifungal agents against biofilms formed by clinical isolates of different Candida and Aspergillus species. Antimicrob Agents Chemother. 2011. 55:3031–3035.