Prosthetic Aortic Valve Endocarditis Due to Candida glabrata Successfully Treated With Intravenous Micafungin Followed by Oral Fluconazole Without Surgery: A Case Report and Literature Review

Fungal endocarditis (FE) is an uncommon and life-threatening disease with unacceptably high mortality rates. Only a handful of cases of FE caused by <i>Candida glabrata</i> have been reported in the literature so far. We present a case of <i>C. glabrata</i> prosthetic valve endocarditis (PVE) in a 59-year-old woman with a history of prosthetic aortic valve who was admitted after outpatient blood cultures came positive for yeast (later identified as <i>C. glabrata</i>). A trans-esophageal echocardiogram showed vegetation on the prosthetic aortic valve. The patient was successfully treated with intravenous (IV) micafungin as she was deemed unfit for valve replacement surgery due to multiple high-risk comorbidities. The patient was treated with six weeks of IV micafungin followed by oral fluconazole for lifelong suppression, and she remained well at follow-up six months later. In this report, we review the latest literature on FE and discuss the role of antifungal therapy in its management.