Summary
Definition
History and exam
Key diagnostic factors
- fever
Other diagnostic factors
- tachycardia
- tachypnea
- hypotension
- poor capillary refill
- acute mental confusion
- decreased urine output
- low oxygen saturation
- rash
- hepatosplenomegaly
- hypothermia
Risk factors
- use of central venous catheter
- exposure to broad-spectrum antibiotics
- hemodialysis
- surgery
- parenteral nutrition
- immunosuppressants (e.g., chemotherapy, systemic corticosteroids, biologic and other immunosuppressants)
- colonization at multiple sites
- intravenous drug use
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- blood culture
- CBC
- ABG
- lactate levels
- coagulation studies
- renal function tests
- liver function test
- serum glucose
Pruebas diagnósticas que deben considerarse
- 1,3-beta-D-glucan
- T2 magnetic resonance assay
- tissue biopsy
Pruebas emergentes
- polymerase chain reaction
- matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry
Algoritmo de tratamiento
suspected diagnosis
confirmed diagnosis: non-neutropenic patients (no complications)
confirmed diagnosis: neutropenic patients (no complications)
confirmed diagnosis: with complications
Colaboradores
Autores
Brenda L. Tesini, MD
Assistant Professor
Infectious Diseases
Departments of Medicine and Pediatrics
University of Rochester Medical Center
Rochester
NY
Divulgaciones
BLT has received honoraria from Merck for educational contributions unrelated to this topic.
Agradecimientos
Dr Brenda L. Tesini would like to gratefully acknowledge Dr Jack D. Sobel and Dr Sanjay G. Revankar, previous contributors to this topic.
Divulgaciones
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 por pares
John Fisher, MD
Professor of Medicine
Department of Medicine
Medical College of Georgia
Augusta
GA
Divulgaciones
JF is an author of a number of references cited in this topic. JF is a member of the speaker's bureau for the following companies: Pfizer, Merck, and Astellas.
Jean-Michel Livrozet, MD
Praticien hospitalier
Service de medecine de la Transplantation et d'Immunologie clinique
Hopital Edouard Herriot
Lyon
France
Divulgaciones
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
Divulgaciones
MF declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
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 Resumen
Centers for Disease Control and Prevention. Candida auris: information for laboratorians and health professionals. Jul 2021 [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 Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Bacterial sepsis
- Drug-induced fever
- Pulmonary embolism
Más DiferencialesGuías de práctica clínica
- Revision and update of the consensus definitions of invasive fungal disease
- Clinical practice guideline for the management of candidiasis
Más Guías de práctica clínica
Inicie sesión o suscríbase para acceder a todo el BMJ Best Practice
El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad