Mycamine (micafungin) / Astellas - LARVOL DELTA

In vitro activity of rezafungin against bloodstream and intra-abdominal Candida isolates: a large EUCAST-based study. (PubMed, Clin Microbiol Infect) - "Rezafungin demonstrated in vitro activity against a large collection of Candida spp. isolates from bloodstream and intra-abdominal infections. Most rezafungin-resistant isolates harboured fks mutations and were also resistant to anidulafungin."

Journal • Preclinical • Candidiasis • Infectious Disease

Clinical and Microbiological Characteristics of Early Candidozyma auris Cases in a Tertiary Hospital in Istanbul, Türkiye: A Retrospective Case Series. (PubMed, Antibiotics (Basel)) - "Early institutional C. auris cases in this tertiary hospital occurred predominantly among elderly, critically ill patients with prolonged healthcare exposure, invasive devices, and extensive antimicrobial use. The findings support the need for early laboratory recognition, cautious interpretation of commercial AFST results, particularly given the propensity of Sensititre YeastOne to overestimate amphotericin B resistance, strengthened infection control practices, and multicenter studies incorporating molecular typing to clarify transmission dynamics and antifungal resistance patterns."

Journal • Retrospective data • Critical care • Infectious Disease

Clinical management, antifungal susceptibility, and predictors of 28-day mortality in Candidozyma auris candidemia: a single-center cohort study. (PubMed, Med Mycol) - "Resistance rates were 95.1% for fluconazole, 31.2% for amphotericin B, and 1.3% for both anidulafungin and micafungin; multidrug resistance rate was 28.6%, and no isolate met the definition of pandrug resistance. Mortality in C. auris candidemia was mainly associated with baseline comorbidity burden and acute organ dysfunction. Local susceptibility surveillance and early recognition of high-risk patients may support treatment and infection-control strategies."

Journal • Critical care • Infectious Disease

Donor-Derived Disseminated Toxoplasmosis After Liver Transplant (ACG 2026) - "He was empirically treated with meropenem and micafungin...Atovaquone should be considered as a second line option for patients at risk of toxoplasmosis who cannot tolerate TMP-SMX due to its activity against both Toxoplasma and Pneumocystis . Figure: Table 1: Infection status of donor and recipient prior to transplant. Figure: Table 2: Results of initial infectious laboratory workup."

Cholestasis • Fibrosis • Hepatology • Immunology • Infectious Disease • Liver Failure • Nephrology • Renal Disease • Septic Shock • Transplantation

Polymicrobial Spontaneous Fungal and Bacterial Peritonitis With Candida albicans in Decompensated Cirrhosis: A Case Report of a Rare and Life-Threatening Complication (ACG 2026) - "She was started on piperacillin-tazobactam and micafungin. Clinicians should obtain routine fungal cultures and initiate early echinocandin therapy in cirrhotic patients with peritonitis failing standard antibiotics. Figure: Table 1: Runyon Criteria Assessment Secondary vs. Spontaneous Peritonitis Figure: Table 2: Ascitic Fluid and Serum Biochemical Analysis"

Case report • Clinical • Addiction (Opioid and Alcohol) • CNS Disorders • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hepatic Encephalopathy • Hepatology • Immunology • Infectious Disease • Liver Cirrhosis • Peptic Ulcer • Thrombocytopenia

An Uncommon Cause of Upper Gastrointestinal Hemorrhage: Acute Esophageal Necrosis With Candida glabrata Fungemia (ACG 2026) - "Micafungin was initiated and transitioned to fluconazole based on susceptibility testing...He was discharged on fluconazole and pantoprazole for eight weeks, with no recurrent bleeding at two-week follow-up...Endoscopy was essential not only for diagnosis but for identifying necrosis predisposing to systemic infection. Physicians should suspect AEN in patients with DKA and upper GI bleeding, recognize necrotic mucosa as a potential infectious source, and monitor vigilantly for septic complications."

Acute Kidney Injury • Addiction (Opioid and Alcohol) • Diabetes • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Hematological Disorders • Hypotension • Infectious Disease • Metabolic Disorders • Nephrology • Ocular Infections • Ocular Inflammation • Ophthalmology • Renal Disease • Thrombocytopenia

Multifocal Intra-Abdominal Abscesses Secondary to Invasive Candidiasis: A Case Report (ACG 2026) - "Percutaneous drainage was performed, and cultures grew Candida glabrata , prompting initiation of micafungin...Figure: Loculated appearing fluid collection within the ventral abdomen extending anterior to the liver which was newly developed from imaging on admission, measuring up to 13.4 x 5.0 cm. Cultures following aspiration were positive for Candida glabrata."

Case report • Clinical • Back Pain • Candidiasis • Cardiovascular • CNS Disorders • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Musculoskeletal Pain • Renal Disease • Respiratory Diseases • Septic Shock

Multifocal Verrucous Esophageal Carcinoma (VEC) Arising in Refractory Candida Esophagitis (ACG 2026) - "Initial antifungal treatments (fluconazole, itraconazole, and micafungin) were unsuccessful in eradicating the infection. Deeper tissue acquisition and multidisciplinary review are critical to establish a diagnosis. Figure: Upper third of the esophagus: stenosis/stricture and polypoid mass Figure: Lower third of the esophagus: mass"

Candidiasis • Diabetes • Esophageal Cancer • Gastrointestinal Disorder • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Oncology • Squamous Cell Carcinoma

A Fungal Sequela of Biliary Intervention: Candida Pyogenic Liver Abscess in Pancreatic Malignancy (ACG 2026) - "He received 1st cycle of palliative gemcitabine/paclitaxel 6 days prior to presentation...He received IV fluids, blood cultures were obtained, and broad-spectrum antimicrobial therapy with vancomycin, meropenem, and micafungin was initiated...Micafungin was restarted and ceftriaxone was continued. On discharge, antimicrobials were changed to oral fluconazole, and amoxicillin/clavulanate...Figure: CT Abdomen Pelvis with and without contrast remarkable for hypodense collection containing foci of gas in the caudate lobe 4.5 x 3 cm concerning for abscess, splenomegaly, portal vein thrombosis. Figure: MRI Abdomen Pelvis with and without contrast remarkable for caudate lobe abscess, progressive multifocal cholangitis, and multifocal intrahepatic dilated biliary radicles/developing abscesses."

Biliary Cancer • Cardiovascular • Diabetes • Hepatology • Hypotension • Infectious Disease • Metabolic Disorders • Oncology • Pancreatic Adenocarcinoma • Septic Shock • Thrombosis • Type 2 Diabetes Mellitus

Mucormycosis Peritonitis in a Patient With Decompensated Alcohol-Associated Cirrhosis (ACG 2026) - "Prednisone was discontinued; ceftriaxone was initiated for spontaneous bacterial peritonitis...Antimicrobials were broadened to vancomycin, meropenem and micafungin...Liposomal amphotericin B was initiated then transitioned to posaconazole...Clinicians should maintain a high index of suspicion for invasive mold infection in cirrhosis patients with refractory secBP despite broad-spectrum antimicrobial therapy. Figure: Figure 1A: Ultrasound of Complex Ascites on Day 3 of Hospitalization Figure: Figure 1B: Ultrasound of Complex Ascites on Day 3 of Hospitalization"

Clinical • CNS Disorders • Fibrosis • Hepatic Encephalopathy • Hepatology • Immunology • Infectious Disease • Inflammation • Renal Disease • Septic Shock

Opportunistic Fungal Peri-Splenic Abscess and Pancreato-Pleural Fistula in Non-Necrotizing Pancreatitis: A Case of Dual-Pathway Ductal Disruption (ACG 2026) - "Conservative management was insufficient; the patient ultimately required micafungin, and serial percutaneous drainage, with clinical and radiographic improvement...Endoscopic retrograde cholangiopancreatography (ERCP). (A) Contrast extravasation from the pancreatic tail into the retroperitoneal space (yellow star); high grade pancreatic duct stricture at the level of the pancreatic head (yellow arrow) (B) Successful placement of a transpapillary pancreatic duct stent (yellow arrowheads)."

Clinical • Infectious Disease • Pancreatitis • Pulmonary Disease • Respiratory Diseases

Malignant Cholecystocolohepatic Fistula Complicated by Intrahepatic Perforation in Advanced Gallbladder Carcinoma (ACG 2026) - "Palliative treatment was initiated with cisplatin, gemcitabine, and durvalumab...Blood cultures also grew Candida species, which was treated with micafungin...Axial contrast-enhanced CT two months later, demonstrating new gas in the gallbladder and fluid and gas collection in the liver abutting the gallbladder, measuring 4.3 x 3.9 cm (white arrow). C and D. Fluoroscopic cholangiogram images obtained during placement of cholecystectomy tube demonstrate a cholecystocolohepatic fistula (white arrow) with contrast insinuating into the hepatic fluid collection (white arrow) as well as the colon at the hepatic flexure (black arrow)."

Metastases • Biliary Cancer • Biliary Tract Cancer • Gallbladder Cancer • Gastroenterology • Gastrointestinal Disorder • Hepatology • Infectious Disease • Oncology • Septic Shock • Solid Tumor

When the Stomach Reaches the Heart: Gastropericardial Fistula from an Ulcerated Intrathoracic Stomach Causing Fungal Pericarditis (ACG 2026) - "He was managed with strict NPO, TPN, broad-spectrum antibiotics, and micafungin before transfer to a tertiary foregut/thoracic surgery center...Interval healing of gastropericardial fistula. Endoscopic view demonstrating near-complete closure of the prior fistulous tract after EndoVAC therapy, with only a small residual mucosal defect and surrounding granulation/inflammatory changes."

Atrial Fibrillation • Cardiovascular • Gastroenterology • Hematological Disorders • Infectious Disease • Peptic Ulcer • Pulmonary Disease • Respiratory Diseases • Septic Shock

Hiding in Plain Sight: A Case of Invasive Candidiasis Lurking Beneath Normal Mucosa (ACG 2026) - "Given the risk of deep tissue complications, the patient was started on intravenous (IV) Micafungin inpatient, followed by a transitional three-week course of oral fluconazole on discharge...Top picture: 2nd portion of duodenum. Bottom picture: duodenal bulb."

Clinical • Candidiasis • Diabetes • Fibrosis • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Metabolic Disorders • Primary Biliary Cholangitis • Type 2 Diabetes Mellitus

Code GI: Was It Worth It? A Gastropulmonary Fistula After Esophagectomy and Gastric Pull-Up Manifesting as Respiratory Failure (ACG 2026) - "He was treated with micafungin and zosyn. Esophagogastroduodenoscopy showing a non-bleeding gastric ulcer (yellow square). Figure: Figure 2: Computed Tomography of the thorax with oral contrast demonstrating a fistula between gastric pull-up and right lower lobe of the lung (red circle)."

Esophageal Cancer • Gastric Adenocarcinoma • Peptic Ulcer • Respiratory Diseases • Septic Shock • Solid Tumor

When the Barrier Breaks: Fatal Invasive Candida Guilliermondii Colitis in Severe Gastrointestinal GVHD (ACG 2026) - "Case Description/ A 43-year-old patient with relapsed mixed phenotype acute leukemia underwent second allogeneic stem cell transplant with double 4/8 umbilical cord donors after Flu/Mel conditioning and cyclosporine/MMF prophylaxis...Necrosis raised concern for fungal colitis, prompting isavuconazole and ruxolitinib escalation to 10 mg BID...Despite antibiotics, micafungin/isavuconazole, and vedolizumab, she died from recurrent GI bleeding due to Candida superinfection of severe, treatment-refractory GVHD enterocolitis...Figure: Figure 2. Laboratory trends through the course"

Candidiasis • Gastroenterology • Gastrointestinal Disorder • Graft versus Host Disease • Hematological Malignancies • Immunology • Infectious Disease • Leukemia

The Pancreas Strikes Back: Necrotizing Pancreatitis as a Devastating Complication of GLP-1 Receptor Agonist Therapy (ACG 2026) - "Fever and leukocytosis prompted IV meropenem and micafungin. Figure: Figure 2. 43 day post-admission coronal/axial CT abdomen with interval worsening of peripancreatic edema and enlarging regions of hypoenhancement reflecting worsening pancreatic necrosis (see ellipses)."

Acute Kidney Injury • Asthma • Cardiovascular • Cholestasis • Diabetes • Diabetic Nephropathy • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Hepatology • Hypertension • Hypotension • Immunology • Infectious Disease • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease • Obesity • Pancreatitis • Renal Disease • Respiratory Diseases • Type 2 Diabetes Mellitus

Fatal Case of Severe Fever with Thrombocytopenia Syndrome Complicated by Profound Neutropenia and Invasive Trichosporonosis. (PubMed, J Infect Chemother) - "A 71-year-old woman was clinically diagnosed with hemophagocytic lymphohistiocytosis, for which she received corticosteroids and etoposide. She was transferred to our hospital and diagnosed with SFTS, and favipiravir was immediately initiated. She developed profound neutropenia and subsequently progressed to respiratory failure necessitating mechanical ventilation, for which she was empirically treated with piperacillin/tazobactam and micafungin. Shortly thereafter, progressively elevated serum Aspergillus galactomannan antigen levels raised concern for invasive fungal infection, particularly invasive pulmonary aspergillosis, prompting a switch in antifungal therapy to isavuconazole...Despite antifungal treatment and intensive supportive care, the patient died of multiple organ failure. This case highlights the need for close hematologic monitoring and vigilance for invasive fungal infections, including uncommon pathogens such as Trichosporon species, in patients with SFTS."

Journal • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Immunology • Infectious Disease • Neutropenia • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Thrombocytopenia

Antifungal therapy for newborn infants with invasive fungal infection. (PubMed, Cochrane Database Syst Rev) - "The evidence is very uncertain about the effect of fluconazole or micafungin on death before hospital discharge, adverse reactions attributed to the antifungal agent that result in discontinuation, or length of hospital stay, when compared to amphotericin B. The evidence is very uncertain about the effect of caspofungin on death before hospital discharge, or adverse reactions attributed to the antifungal agent that result in discontinuation, when compared to amphotericin B. The evidence is very uncertain about the effect of micafungin on death before hospital discharge or adverse reactions attributed to the antifungal agent that result in discontinuation, when compared to fluconazole. Large RCTs with low risk of bias are required to compare antifungal drugs, drug preparations or drug combinations for treating newborn infants with invasive fungal infection. Future RCTs should stratify participants by gestational age and should also measure antifungal resistance and..."

Clinical • Journal • Review • CNS Disorders • Infectious Disease

Intravenous micafungin as a potential rescue treatment for recurrent suspected Trichophyton indotineae dermatophytosis: a four-case series (EADV 2026) - No abstract available

Clinical • Dermatology

Comparative and Subtractive Genomics Analysis of Multidrug-Resistant Klebsiella pneumoniae Strains for Novel Target Identification and Drug Repurposing Strategies. (PubMed, Int J Microbiol) - "Subsequent molecular dynamics simulations, including root mean square deviation (RMSD), root mean square fluctuation (RMSF), radius of gyration (Rg), hydrogen-bond occupancy, principal component analysis (PCA), and PCA-based free energy landscape (FEL) analyses, consistently identified tenapanor, micafungin, deferoxamine, and cobicistat as the most stable protein-ligand complexes, with tenapanor exhibiting the most favorable overall structural and thermodynamic stability profile. These findings identify accD as a promising therapeutic target in MDR K. pneumoniae and suggest several FDA-approved compounds as potential candidates for drug repurposing. Although experimental validation is needed to confirm their biological activity and therapeutic potential, this study demonstrates the potential of integrating comparative genomics with molecular dynamics analyses to support antimicrobial target identification and drug repurposing against MDR bacterial pathogens."

Journal • Infectious Disease • Pneumonia

Antifungal resistance and poor clinical outcome rates of Candida auris in mainland China: A systematic review and meta-analysis. (PubMed, Front Microbiol) - "The resistance rates of caspofungin, micafungin, and anidulafungin were 3% (95%CI: 0%-11%), 2% (95%CI: 0%-4%), and 1% (95%CI: 0%-3%), respectively...Fluconazole is not an appropriate choice for treating C. auris strains in mainland China, while echinocandins should be the primary treatment option...Patients with C. auris colonization or infection exhibit variable clinical outcomes. Clinical practice should prioritize routine laboratory antifungal susceptibility surveillance, standardized hospital infection control measures, and targeted interventions to improve patient clinical outcomes."

Clinical data • Journal • Retrospective data • Review • Infectious Disease

X-linked hyper-IgM syndrome presenting as severe Pneumocystis pneumonia in a 6-month-old infant: a case report. (PubMed, Front Immunol) - "He was treated with mechanical ventilation, trimethoprim-sulfamethoxazole (TMP-SMX), micafungin, corticosteroids, and intravenous immunoglobulin (IVIG), and was discharged after 36 days. Early aggressive management and evaluation for hematopoietic stem cell transplantation are essential to improve outcomes.Serial immunological evaluation is essential in infants with recurrent or opportunistic infections, as persistently low IgA and declining T-cell counts-even when initial screening appears normal-should prompt genetic evaluation for underlying immunodeficiency. Early aggressive management and evaluation for hematopoietic stem cell transplantation are essential to improve outcomes."

IO biomarker • Journal • Bone Marrow Transplantation • Immunology • Infectious Disease • Pneumonia • Primary Immunodeficiency • Respiratory Diseases • Transplantation • CD40LG

In Vitro Activity and In Vivo Efficacy in a Murine Model of Rezafungin, Anidulafungin, Caspofungin, and Micafungin Against the Fifth Clade of Candida (Candidozyma) auris. (PubMed, J Fungi (Basel)) - "Pseudohyphae production was common in controls, but not in echinocandin-treated mice. Rezafungin activity was comparable to or better than the three previously approved echinocandins."

Journal • Preclinical • Infectious Disease

Blood Stream Infections due to Candida Species: Prevalence, Risk Factors, Mortality, and Susceptibility Profile Over 3-Year Period: A Single Center Study. (PubMed, Int J Microbiol) - "Fluctuating trends in antifungal susceptibility of non-albicans Candida were observed, with increasing resistance to azoles, while increasing susceptibility to micafungin...The continuous rise of antifungal resistance and spread of non-albicans Candida species highlight the need for implementing rigorous control measures in healthcare facilities. Improving candidemia outcomes requires prompt identification of high-risk patients and targeted therapies."

Journal • Infectious Disease • Respiratory Diseases