amphotericin-b and Arterial-Occlusive-Diseases

Topics: Aged; Amphotericin B; Antifungal Agents; Arterial Occlusive Diseases; Cardiac Surgical Procedures; Device Removal; Endarterectomy; Endocarditis; Fatal Outcome; Female; Femoral Artery; Heart Valve Diseases; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Leg; Mitosporic Fungi; Mitral Valve; Mycoses; Prosthesis-Related Infections; Pyrimidines; Reoperation; Triazoles; Voriconazole

We describe a patient who developed Candida albicans brain abscess associated with prominent vascular invasion following an episode of central venous catheter-related fungemia. The increasing population of immunosuppressed patients and the frequent use of broad-spectrum antimicrobials, corticosteroids, chemotherapeutics, organ transplantation, and prolonged supportive measures are responsible for an increasing incidence of candidal infections. Brain abscess is a rare complication of candidemia but may be expected to become more common as venous catheter-related fungemia is encountered more frequently.

Topics: Amphotericin B; Arterial Occlusive Diseases; Brain; Brain Abscess; Candida albicans; Candidiasis; Carotid Artery Diseases; Carotid Artery, Internal; Catheterization, Central Venous; Cerebral Arteries; Craniotomy; Drug Therapy, Combination; Flucytosine; Fungemia; Humans; Magnetic Resonance Angiography; Male; Middle Aged; Tomography, X-Ray Computed

A patient suffering from Candida endocarditis presented with a gangrenous foot. In addition to arterial embolism, occult mycotic aneurysms were found by arteriography. Clinical cure was achieved with a combination of chemotherapy and valvular débridement, but viable Candida persisted in an easily removable embolus. Occult peripheral vascular lesions may be a continuing source of Candida sepsis in some patients.

Topics: Adult; Amphotericin B; Aneurysm, Infected; Aortography; Arterial Occlusive Diseases; Arteritis; Candidiasis; Drug Therapy, Combination; Endocarditis; Female; Flucytosine; Gangrene; Humans; Mitral Valve Insufficiency

Topics: Amphotericin B; Arterial Occlusive Diseases; Aspergillosis; Aspergillus fumigatus; Embolism; Endocarditis; Femoral Artery; Humans; Male; Middle Aged; Mitral Valve; Myocardium