Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Apr 18:40:e02232.
doi: 10.1016/j.idcr.2025.e02232. eCollection 2025.

Rezafungin for suppressive therapy of Candida auris in a patient with a left ventricular assist device (LVAD)

Matthew A Stack  1   2 , Luis Ostrosky-Zeichner  1 , Rodrigo Hasbun  1 , Sun O Park  1 , Jessica Babic  3 , Mona Kapadia  1
Affiliations
Case Reports

Rezafungin for suppressive therapy of Candida auris in a patient with a left ventricular assist device (LVAD)

Matthew A Stack et al. IDCases. .

Abstract

Introduction: Invasive candidiasis is a common healthcare-associated infection with significant morbidity and mortality. Candida auris in particular has emerged as a problematic and challenging healthcare-associated infection, especially with regards to infections involving left ventricular assist devices (LVADs). There is a paucity of evidence on the best management of these particular types of infections. Rezafungin is a newly-approved echinocandin and an important new tool in the management of invasive candidiasis. We report the novel use of rezafungin for suppressive therapy in a patient with an LVAD-associated C. auris infection.

Case: The patient is a 57-year-old male with a past medical history most notable for heart failure with ischemic cardiomyopathy. The patient underwent LVAD placement and his post-LVAD placement clinical course was notable for recurrent C. auris fungemia. The patient was originally on indefinite micafungin therapy, but was eventually switched to once-weekly rezafungin as this was felt to be safer, easier, and more convenient for the patient. He did well on weekly rezafungin for about 4 months but did eventually develop breakthrough C. auris fungemia.

Conclusions: Rezafungin is a promising new antifungal in the armamentarium of drugs for treatment of invasive candidiasis, notably C. auris. Though the patient did develop a breakthrough C. auris bloodstream infection while on rezafungin therapy, his infection was well-controlled for a little over 4 months, which prevented any C. auris-related hospital admissions during that time period. This case represents the first example of rezafungin being used for an LVAD-associated C. auris infection.

Keywords: Candida auris; LVAD; LVAD-associated infections; Rezafungin; Suppressive therapy.

PubMed Disclaimer

Conflict of interest statement

LO has received consulting honoraria from Cidara and Melinta. Authors MS, RH, SP, JB, and MK declare they have no financial interests or associations that might pose a conflict of interest.

Figures

Fig. 1
Fig. 1
a: Timeline of key events after patient’s LVAD placement. For the sake of brevity, note that there were multiple non-infectious complications in the period immediately after LVAD placement that are not specifically listed on the timeline. Fig. 1b: Timeline of key events after the patient’s admission for breakthrough C. auris fungemia while on rezafungin.
Fig. 1
Fig. 1
a: Timeline of key events after patient’s LVAD placement. For the sake of brevity, note that there were multiple non-infectious complications in the period immediately after LVAD placement that are not specifically listed on the timeline. Fig. 1b: Timeline of key events after the patient’s admission for breakthrough C. auris fungemia while on rezafungin.
Fig. 2
Fig. 2
PET-CT showing persistent FDG uptake surrounding the outflow tract tubing (red arrow).
See this image and copyright information in PMC

References

    1. Tsay S.V., Mu Y., Williams S., et al. Burden of candidemia in the United States, 2017. Clin Infect Dis. 2020;71(9):e449–e453. doi: 10.1093/cid/ciaa193. - DOI - PubMed
    1. Benedict K., Jackson B.R., Chiller T., Beer K.D. Estimation of direct healthcare costs of fungal diseases in the United States. Clin Infect Dis. 2019;68(11):1791–1797. doi: 10.1093/cid/ciy776. - DOI - PMC - PubMed
    1. Morgan J., Meltzer M.I., Plikaytis B.D., et al. Excess mortality, hospital stay, and cost due to candidemia: a case-control study using data from population-based candidemia surveillance. Infect Control Hosp Epidemiol. 2005;26(6):540–547. doi: 10.1086/502581. - DOI - PubMed
    1. Ben-Ami R. Treatment of invasive candidiasis: a narrative review. J Fungi (Basel) 2018;4(3) doi: 10.3390/jof4030097. - DOI - PMC - PubMed
    1. Pappas P.G., Kauffman C.A., Andes D.R., et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1–e50. doi: 10.1093/cid/civ933. - DOI - PMC - PubMed

Publication types

LinkOut - more resources