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You are here: Contents > 2017 > Volume 26 Number 2 March 2017 > INFECTIVE ENDOCARDITIS > (1→3)-β-D-Glucan Assay in Monitoring Response to Anti-Fungal Therapy in Fungal Endocarditis

(1→3)-β-D-Glucan Assay in Monitoring Response to Anti-Fungal Therapy in Fungal Endocarditis

Jihad Slim1,4, Christopher Saling2,4,5, Maria Szabela1,4, Melinda Brown1,4, Tamara Johnson1,4, Irvin Goldfarb3,4

1Department of Infectious Disease, Saint Michael’s Medical Center, Newark, NY, USA
2Department of Internal Medicine, Saint Michael’s Medical Center, Newark, NY, USA
3Department of Cardiology, Saint Michael’s Medical Center, Newark, NY, USA
4New York Medical College, Valhalla, NY, USA
5Electronic correspondence: christopher.saling@gmail.com

Background and aim of the study: A case is reported of Candida glabrata infective endocarditis (IE) treated without surgical intervention. The study aim was to: (i) briefly discuss the outcomes of other documented cases of fungal IE managed medically with fluconazole; (ii) discuss the (1→3)-β-D-glucan assay and its previously studied role in the diagnosis of invasive fungal infections; and (iii) examine a possible application of the (1→3)-β-D-glucan assay to monitor response to antifungal treatment in patients with Candida endocarditis.

Methods: The serum Fungitell assay was used to trend (1→3)-β-D-glucan in a patient with Candida endocarditis to determine treatment effectiveness with fluconazole, to provide an appropriate end date for antifungal therapy, and to survey infection


suppression while off treatment.

Results: The (1→03)-β-D-glucan assay began trending downwards at 197 days into treatment with oral fluconazole. After 16 months of therapy, fluconazole was stopped due to transaminitis. (1→3)-β-Dglucan levels were checked six weeks after the discontinuation of treatment and were negative. The patient has now been off therapy for 21 weeks with no signs of clinical disease, and values remain negative.

Conclusion: The present case indicates that a trending (1→3)-β-D-glucan assay may have valuable application in monitoring treatment response and infection suppression for Candida endocarditis.

The Journal of Heart Valve Disease 2017;26:208-210


(1→3)-β-D-Glucan Assay in Monitoring Response to Anti-Fungal Therapy in Fungal Endocarditis

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