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Systemic candidiasis

Última revisão: 23 Sep 2025
Última atualização: 10 Sep 2025

Resumo

Definição

History and exam

Key diagnostic factors

  • fever
Full details

Other diagnostic factors

  • tachycardia
  • tachypnea
  • hypotension
  • poor capillary refill
  • acute mental confusion
  • decreased urine output
  • low oxygen saturation
  • rash
  • hepatosplenomegaly
  • hypothermia
Full details

Risk factors

  • use of central venous catheter
  • exposure to broad-spectrum antibiotics
  • renal dialysis
  • surgery
  • parenteral nutrition
  • use of immunosuppressants
  • colonization at multiple sites
  • intravenous drug use
Full details

Diagnostic investigations

1st investigations to order

  • blood culture
  • CBC
  • ABG
  • lactate levels
  • coagulation studies
  • renal function tests
  • LFT
  • serum glucose
Full details

Investigations to consider

  • 1,3-beta-D-glucan
  • matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry
  • T2 magnetic resonance assay
  • tissue biopsy
  • ultrasound
  • CT scan
  • MRI
  • 18F-FDG PET/CT
Full details

Emerging tests

  • polymerase chain reaction

Treatment algorithm

INITIAL

suspected diagnosis

ACUTE

confirmed diagnosis: non-neutropenic patients (no complications)

confirmed diagnosis: neutropenic patients (no complications)

confirmed diagnosis: with complications

Contributors

Authors

Brenda L. Tesini, MD

Assistant Professor

Infectious Diseases

Departments of Medicine and Pediatrics

University of Rochester Medical Center

Rochester

NY

Disclosures

BLT is a Merck Manuals editorial board member, and Society for Healthcare Epidemiology of America (SHEA) Guidelines Liaison Committee vice chair. She has received grant funding from the Centers for Disease Control (CDC).

Ramia Zakhour, MD

Associate Professor

Pediatric Infectious Diseases

Department of Pediatrics

McGovern Medical School

Houston

TX

Disclosures

RZ declares that she has no competing interests.

Acknowledgements

Dr Brenda L. Tesini and Dr Ramia Zakhour would like to gratefully acknowledge Dr Jack D. Sobel and Dr Sanjay G. Revankar, previous contributors to this topic.

Disclosures

JDS declares that he has no competing interests. SR has received grants for research from Astellas, Gilead, and Merck, and has been involved in clinical trials for Cidara and Astellas.

Revisores

Paschalis Vergidis, MD, MSc

Associate Professor

Infectious Diseases

Mayo Clinic College of Medicine and Science

Rochester

MN

Declarações

PV has received research funding from Cidara, Scynexis, F2G, Ansun and has served on advisory roles for AbbVie and Scynexis (all fees paid to Mayo Clinic). He has received honoraria from the Merck Manuals and Current Fungal Infection Reports.

Jean-Michel Livrozet, MD

Praticien hospitalier

Service de medecine de la Transplantation et d'Immunologie clinique

Hopital Edouard Herriot

Lyon

France

Declarações

JML has been invited by Astellas, the manufacturer of micafungin, to attend a symposium, and invited by Gilead Sciences, manufacturer of liposomal amphotericin B, to attend different HIV conferences, and has been paid by Gilead Sciences for running HIV educational programs.

Matthew Falagas, MD, MSc, DSc

Director

Alfa Institute of Biomedical Sciences

Marousi

Athens

Greece

Declarações

MF declares that he has no competing interests.

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Referências

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Principais artigos

Tsay SV, Mu Y, Williams S, et al. Burden of candidemia in the United States, 2017. Clin Infect Dis. 2020 Dec 3;71(9):e449-53.Texto completo  Resumo

Centers for Disease Control and Prevention. ​Candida auris (C. auris): C.auris for healthcare and laboratory professionals. 2024 [internet publication].Texto completo

Pappas PG, Kauffman CA, Andes DR, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016 Feb 15;62(4):e1-50.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

    • Bacterial sepsis
    • Drug-induced fever
    • Pulmonary embolism
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Consensus guidelines for the diagnosis and management of invasive candidiasis in haematology, oncology and intensive care settings, 2021
    • Revision and update of the consensus definitions of invasive fungal disease
    Mais Diretrizes
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