First Russian Experience of Successful Use of Caspofungin in Invasive Candidiasis in Patient with Severe Hepatic Failure (Clinical case)

Abstract

A clinical case of the successful use of caspofungin for the treatment of invasive candidiasis, caused by fluconazole- and voriconazole-resistant strain of Candida glabrata, in the patient with severe hepatic failure (Child-Pugh score of 12) due to decompensation of the HBV-associated liver cirrhosis is presented. The therapy with caspofungin in standard dose (70 mg once on the first day, followed by 50 mg once a day for the next 13 days) led to the reduction of clinical symptoms of invasive candidiasis and eradication of causative agent, there was no deterioration in laboratorial markers of hepatic function, hepatocellular damage and intrahepatic cholestasis. For the next 47 days of being in the hospital no relapse of invasive candidiasis occured. It seems that summarizing of results of the same clinical cases may become the first step in safety evaluation of caspofungin usage in patients with severe hepatic failure (Child-Pugh score >9).