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24 April 2011

Candidemia in children after complex congenital heart defects surgery treated with caspofungin – our own experience and a review of literature

Radoslaw JaworskiABEF, Ninela IrgaADE, Ireneusz HaponiukBCD, Maciej ChojnickiBCE, Elzbieta ArlukowiczCDF, Mariusz SteffekAEF, Mariusz SrokaCD, Katarzyna Gierat-HaponiukEF, Jacek JuscinskiEF, Lucyna PalkowskaBDE, Aneta SendrowskaBE, Wojciech KosiakBCD

DOI: 10.12659/MSM.881751

Med Sci Monit 2011; 17(5): PH35-39

Abstract

Background: Invasive fungal infections due to Candida species constitute an increasing clinical problem. There are no guidelines for the management of candidemia in children undergoing surgical procedures for congenital heart defects (CHD). The aim of the study was to draw attention to the problem of candidemia in children who are operated on due to congenital heart defects.
Material/Methods: We retrospectively analyzed medical documentation of 307 children with congenital heart defects treated in 1 clinical centre in Poland, from whom we selected those diagnosed with candidemia during the postoperative period. Next, we analyzed in detail the clinical course of invasive candidiasis in each individual and we performed an analysis of risk factors that lead to candidemia.
Results: In the analyzed period, among 307 children who underwent surgical procedures, we observed 2 cases of candidemia (0.65%) which were effectively cured with caspofungin. No adverse effects were observed after treatment with the drug.
Conclusions: Candidemia in children who undergo surgical treatment of congenital heart defects is an important factor that can influence final clinical results. Caspofungin may be an effective therapeutic option when treating candidemia in children after extensive cardiosurgical procedures.

Keywords: Heart Defects, Congenital - surgery, Echinocandins - therapeutic use, Child, Cardiac Surgical Procedures - adverse effects, Candidemia - etiology, C-Reactive Protein - metabolism, Antifungal Agents - therapeutic use, Leukocyte Count

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750