Accuracy of matrix-assisted LASER desorption ionization-time of flight mass spectrometry for identification of Candida

Candida endocarditis: Update on management considerations

The rise in incidence rates of invasive candidiasis warrants an increase in attention and efforts toward preventing and treating this virulent infection. Cardiac involvement is one of the most feared sequelae and has a poor prognosis. Despite the introduction of several novel antifungal agents over the past quarter century, complications and mortality rates due to Candida endocarditis have remained high. Although fungal endocarditis has a mechanism similar to bacterial endocarditis, no specific diagnostic criteria or algorithm exists to help guide its management. Furthermore, recent data has questioned the current guidelines recommending a combined approach of antifungal agents with surgical valve or indwelling prostheses removal. With the emergence of multidrug-resistant Candida auris, a focus on improved prophylactic measures and management strategies is necessary.

Candida glabrata Empyema Thoracis—A Post-COVID-19 Complication

The COVID-19 pandemic is associated with a significant increase in the incidence of invasive mycosis, including pulmonary aspergillosis, mucormycosis, and candidiasis. Fungal empyema thoracis (FET) is an uncommon clinical presentation of invasive fungal disease (IFD) associated with significant mortality. Here, we describe the first report of a patient with post-COVID-19 multifocal necrotizing pneumonia complicated by a polymicrobial empyema that included Candida glabrata. Candida empyemas represent another manifestation of a COVID-19-associated fungal opportunistic infection, and this infrequently encountered entity requires a high degree of clinical suspicion for timely identification and management. Therapy for empyemas and other non-bloodstream Candida infections may differ from candidemia due to several pharmacokinetic parameters impacting bioavailability of the antifungal in the affected tissue (e.g., pleural space) and is an area that needs more investigation.