Snapshot A 36-year-old man presents to the emergency department with worsening vision impairment. The patients finds that his field of vision has been increasingly blurry, and his symptoms are associated with fever and generalized malaise. He also endorses to having odynophagia. He has a past medical history of HIV, and he has been non-adherent to his antiretroviral therapy. His temperature is 102°F (38.9°C), blood pressure is 95/68 mmHg, pulse is 112/min, and respirations at 19/min. Ophthalmology was consulted, a dilated exam was performed, and demonstrated chorioretinitis with vitritis involving her left eye. Oral thrush was appreciated on exam. The patient was admitted to the hospital, blood cultures were obtained, and antiretroviral and empiric treatment were started. Blood cultures returned positive for Candida albicans and his empiric treatment was narrowed to micafungin. (Invasive candidemia) Introduction Mechanism of action impairs β-D-glucan synthesis via noncompetitive inhibition of 1,3-β-glucan synthase β-D-glucans are crosslinking components in the cell wall of many fungi Medications anidulafungin caspofungin micafungin Clinical use infections caused by Candida spp. Aspergillus Adverse effects gastrointestinal upset flushing (secondary to histamine release)