Characteristics and Outcomes of Candidemia in Patients with Durable Left Ventricular Assist Device Support

Kaitlyn L. Broderick, Carli J. Peters, Jeremy A. Mazurek, Joyce Wald, Robert S. Zhang, Pavan Atluri, Kim Urgo, Lee Goldberg, Emily A. Blumberg, Blair C. Weikert, Edo Y. Birati

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

There are limited data on the characteristics and clinical course of fungal infections in patients on durable left ventricular assist device (LVAD) support. We sought to further characterize the epidemiology and outcomes of LVAD patients with fungemia. We performed a retrospective review of patients receiving LVAD support from January 2012 through June 2020 at a large academic institution. Among 336 patients on LVAD support, five (1.4%) were diagnosed with fungemia during the study period. Three patients had diabetes with mean hemoglobin A1c 7.1% (R 6.6, 7.4). Fever and leukocytosis (mean white blood count 17.0 thousand/µL [R 12.5, 29.9]) were the most common symptoms. Fungemia was diagnosed early after LVAD implantation (mean 14.4 support days [R 2, 19]). All patients were infected with Candida species, and four isolates were susceptible to fluconazole. Central nervous system outcomes included an ischemic stroke, subarachnoid hemorrhage, and malignant hemorrhagic stroke. Two patients were successfully transplanted, and two patients on destination therapy remain on suppressive fluconazole. In conclusion, fungemia is a rare and severe complication in LVAD patients occurring early postimplant.

Original languageEnglish
Pages (from-to)1044-1047
Number of pages4
JournalASAIO Journal
Volume68
Issue number8
DOIs
StatePublished - 1 Aug 2022

Bibliographical note

Publisher Copyright:
© 2022 ASAIO.

Funding

Disclosure: E.Y.B. received support from Medtronic Inc.—Research support paid to the University.

FundersFunder number
Medtronic

    Keywords

    • Candidemia
    • Fungemia
    • Infection
    • Left ventricular assist device
    • Outcomes

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