A 28-month-old boy developed infection of the pleural cavity and cardiac failure following open-heart surgery for transposition of the great vessels. Treatment with antibiotics, digitalis, aspirin, and a course of hyperbaric oxygen did not alleviate the signs and symptoms. Candida albicans was cultured from the chest tube drainage, a pleural aspirate, the pacemaker wire, urine, and pharynx. Blood and stool cultures were negative for C albicans. There were persistently elevated Candida antibody titers. Only after therapy with clotrimazole, an orally given antifungal drug, was begun did the signs and symptoms of infection disappear and the Candida antibody levels drop to normal. The patient remains well two years postoperatively and has normal Candida antibody levels.
Kozinn PJ, Lynfield J, Seelig MS. Successful Treatment of Systemic Candidiasis Following Cardiac Surgery. Am J Dis Child. 1974;128(1):106-108. doi:10.1001/archpedi.1974.02110260108022