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
