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

William F. Wright | Zendy; Nika Bejou | Zendy; Ryan K. Shields | Zendy; Kieren A. Marr | Zendy; Todd P McCarty | Zendy; Peter G. Pappas | Zendy

Open Access

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

Author(s) -

William F. Wright,

Nika Bejou,

Ryan K. Shields,

Kieren A. Marr,

Todd P McCarty,

Peter G. Pappas

Publication year - 2019

Publication title -

antimicrobial agents and chemotherapy

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 2.07

H-Index - 259

eISSN - 1070-6283

pISSN - 0066-4804

DOI - 10.1128/aac.00512-19

Subject(s) - candida glabrata , micafungin , voriconazole , echinocandin , medicine , fluconazole , fungemia , osteomyelitis , amphotericin b , septic arthritis , central venous catheter , septic shock , surgery , mycosis , sepsis , arthritis , catheter , antifungal , dermatology

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.

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