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Caspofungin in a pediatric patient with persistent candidemia
Karin K Wertz1, Robert K Pretzlaff
1Department of Pediatrics, University of California, Davis Medical Center, Sacramento, CA, USA.
Summary
Caspofungin effectively treated a child with persistent candidemia, leading to recovery without toxicity. This echinocandin antifungal may be a valuable option for severe pediatric fungal infections unresponsive to standard treatments.
Area of Science:
- Pediatric Mycology
- Infectious Diseases
- Pharmacology
Background:
- Persistent fungal infections in children pose significant treatment challenges.
- Echinocandin antifungals offer a newer therapeutic option for invasive fungal diseases.
- Current treatment guidelines for pediatric fungal infections are evolving.
Observation:
- A 3-year-old female presented with persistent candidemia despite treatment with amphotericin B and flucytosine.
- Caspofungin was added to the antifungal regimen after more than five weeks of persistent candidemia.
- The patient was managed in a pediatric intensive care unit at a university teaching hospital.
Findings:
- The addition of caspofungin led to rapid clearance of candidemia.
- The child recovered clinically with no evidence of recurrent fungal infection.
- No overt toxicity was observed during caspofungin treatment.
Implications:
- Caspofungin demonstrated safety and potential efficacy in a pediatric patient with refractory candidemia.
- This case suggests caspofungin could be considered for severe pediatric fungal infections unresponsive to conventional therapies.
- Further research is warranted to establish the role of caspofungin in pediatric antifungal treatment protocols.