A Successful Treatment with Micafungin of Candidemia due to Candida krusei

Abstract

We report a case of candidemia due to Candida krusei after subarachinoid hemorrhage. A 51 year-old male patient consulted us for high fever and increase of CRP 10 days post operation against subarachinoid hemorrhage. There was a temporary decrease in the CRP after administration of ceftazidime (CAZ) but it again when treatment with CAZ was stopped. Because of detected Candida sp. by blood culture, fluconazole was administered i.v. for 5 days, but C. krusei was positive during the treatment. Therefore, fluconazole was replaced with micafungin. The patient became better after the administration with micafungin for 14 days without side effect. Micafungin is effective against candidemia due to C. krusei.

Successful Topical Application of a New Antifungal Agent, Micafungin, in the Treatment of Refractory Fungal Corneal Ulcers

“…19,23,34,35 This new agent has activity against fungal isolates resistant to established antifungal agents, particularly the triazole agent FCZ or polyenes. 34,[36][37][38] Results of studies of caspofungin in the United States and those of MCFG in Japan in candidemia and invasive candidiasis suggest equivalent efficacy to amphotericin B or azoles, with substantially fewer toxic effects. 19,23,36 A very recent study evaluating the antifungal susceptibility of 535 Candida blood isolates in Japan showed that the concentrations of FCZ necessary to inhibit 90% (minimum inhibitory concentration, MIC) of Candida isolates at 24 hours were 0.25 mg/L for C. albicans, 0.5 mg/L for C. parapsilosis, and 4 mg/L for C. glabrata.…”

Echinocandins in the management of invasive fungal infections, part 1

“…38 A single patient with disseminated candidiasis did not respond to a 16-day course of therapy, with a maximum daily dose of 75 mg. Micafungin was recently marketed in Japan, and case reports of successful treatment of candidemia with micafungin can be found in the Japanese medical literature. 39,40 A randomized, double-blind study of 531 patients with invasive candidiasis compared micafungin sodium 100 mg i.v. daily with liposomal amphotericin B 3 mg/kg i.v.…”