A case of recurrent Candida glabrata fungemia and successful treatment with rezafungin

Antifungal resistance in Candida glabrata can develop to different classes of drugs, including the azoles and echinocandins. This organism is known to cause infective endocarditis with a particular predilection for prosthetic valves. Herein we present a case of recurrent fungemia with C. glabrata in a middle-aged woman with Tetralogy of Fallot who had a right ventricle to pulmonary artery conduit, and a transcatheter pulmonary valve replacement in the past. Her isolate showed increasing minimum inhibitory concentrations (MIC) to various antifungals with higher MICs to azoles, including resistance to fluconazole, resulting in limited treatment options. She had affliction of her prosthetic pulmonic valve with C. glabrata and was treated with the second-generation echinocandin, rezafungin, for six months. This case illustrates the tolerability profile of long-term treatment with rezafungin.