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

William F. Wright, Nika Bejou, Ryan K. Shields, Kieren Marr, Todd P. McCarty, Peter G. Pappas

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalAntimicrobial agents and chemotherapy
Volume63
Issue number8
DOIs
StatePublished - Aug 1 2019

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Echinocandins
Candida glabrata
Salvage Therapy
Infectious Arthritis
Amphotericin B
Osteomyelitis
Infection
Fungemia
Central Venous Catheters
Total Parenteral Nutrition
Fluconazole
Complementary Therapies
Crohn Disease
Therapeutics
Voriconazole

Keywords

  • Candida glabrata
  • echinocandin
  • FKS mutation

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Amphotericin B Induction with Voriconazole Consolidation as Salvage Therapy for FKS-Associated Echinocandin Resistance in Candida glabrata Septic Arthritis and Osteomyelitis. / Wright, William F.; Bejou, Nika; Shields, Ryan K.; Marr, Kieren; McCarty, Todd P.; Pappas, Peter G.

In: Antimicrobial agents and chemotherapy, Vol. 63, No. 8, 01.08.2019.

Research output: Contribution to journalArticle

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