Micafungin for Candida Albicans Pacemaker-Associated Endocarditis: A Case Report and Review of the Literature

We report on the treatment with micafungin of a pacemaker-associated endocarditis due to Candida albicans. Antifungal therapy was able to reduce vegetation size from 5 to 1 cm making possible the transvenous removal of the device without a high risk of pulmonary embolism. Noteworthy, a high micafungin concentration was documented into the lead vegetation (10 mu g/g of vegetation tissue) and this may have contributed to the striking size reduction of vegetation.