Medical treatment of a pacemaker endocarditis due to Candida albicans and to Candida glabrata

We describe a case of pacemaker infection due to two fungal species: Candid a albicans and C., glabrata. Transthoracic echocardiography showed a large vegetation on the intraventricular wires, Because of severe underlying dise ases, surgery was believed to be contraindicated. The patient was treated u sing high dose of fluconazole, resulting in clinical improvement and negati ve blood cultures. However, 2 months later, the patient underwent a fatal s troke. At autopsy a large vegetation was found only all along the wires. Po stmortem culture of the infected material was positive for bath C. albicans and C. glabrata. (C) 2000 The British Infection Society.