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Research Snapshot Theater: Infectious Disease/Cardiovascular/Neuroscience, Adult

Rare Case of Candida auris Pericarditis in an ESRD Patient With History of Endocarditis

Tuesday, March 24, 2026
12:30 PM - 1:30 PM Central Time
Location: Connections Central - RST 12

  • Ayman Albittar, MD

    Florida

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • GL

    Gina Lee, MD

    Pulmonary and Critical Care fellow
    Broward Health North

    Disclosure information not submitted.

  • DD

    Danielle De Greef, DO

    Internal Medicine Resident
    Broward Health North

    Disclosure information not submitted.

  • MM

    Mohammed Mohiuddin, MD

    Pulmonary and Critical Care fellow
    Broward Health North

    Disclosure information not submitted.

  • FQ

    Fares Qureiyeh, MD

    Pulmonary and Critical Care Medicine
    Broward Health North

    Disclosure information not submitted.

Introduction: Disseminated Candida auris infection presenting with fungal pericarditis is a life-threatening infection typically associated with immunosuppression, cardiac surgery, or prolonged antibiotic use. Fungal species comprise less than 1% of pericardial infections, with Candida auris—an emerging multidrug-resistant yeast—rarely implicated; only one documented case of Candida auris pericarditis has been reported in the literature, resulting in death.


Description: A 54-year-old man with end-stage renal disease (ESRD) on hemodialysis due to IgA nephropathy, type 2 diabetes, and recent diagnosis of endocarditis at an outside hospital presented with shortness of breath and anemia (hemoglobin 6.0 g/dL). His medical history included ulcerative colitis (post-colectomy), L4-L5 osteomyelitis, stroke, and recent PFO closure. Echocardiography revealed a moderate pericardial effusion, leading to a left anterior thoracotomy with pericardial window creation. Intraoperative pericardial and pleural fluid were cloudy, with WBC 1000/mm³ (neutrophil predominance). Gram stain was negative; cultures grew C. auris. Blood cultures remained sterile. The patient was initially started on micafungin, but due to lack of clinical response, therapy was switched to liposomal amphotericin B while awaiting susceptibility results. He subsequently improved and remains hospitalized under close supervision monitoring.


Discussion: This is the second reported case of C. auris pericarditis worldwide. Risk factors included ESRD, cardiac hardware, and broad-spectrum antibiotic use. The infection remained localized without fungemia, highlighting the importance of direct sampling. Early surgical drainage and rapid microbiological identification allowed for prompt targeted treatment. This case underscores the need to consider fungal etiologies in high-risk ICU patients with pericardial effusion and highlights C. auris as an emerging critical care threat that requires enhanced surveillance and infection control measures.
Sources:
(Ruiz-Gaitán et al., JMM Case Rep 2018).
(Chowdhary et al., PLoS Pathog, 2016; CDC, 2024).