Fungal endocarditis

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(Redirected from Candidal endocarditis)

Background

  • Most commonly caused by yeast within the genus Candida, though many species of Candida are now being reclassified into distinct genera

Management

Yeast-Related Endocarditis

  • Initial treatment with liposomal amphotericin B 3-5 mg/kg IV daily, ± flucytosine 25 mg/kg PO qid
    • Alternative: high-dose echinocandin (caspofungin 150 mg IV daily, micafungin 150 mg IV daily, or anidulafungin 200 mg IV daily)
    • Antifungal therapy should continue for at least 6 weeks after surgery
  • Valve replacement is recommended in essentially all cases of fungal endocarditis
    • In case of prosthetic valve, this should be followed by lifelong suppressive therapy
  • If the valve is not replaced, step-down to lifelong suppressive therapy following treatment is recommended with fluconazole 400-800 mg PO daily