Systemic candidiasis

Systemic candidiasis is an infection of blood or other normally sterile site with Candida species.

Major risk factors are use of central venous catheters, exposure to broad-spectrum antibiotics, and neutropenia.

Blood cultures are only 70% to 80% sensitive in diagnosis.

Treatment should be started within 24 hours of diagnosis to improve outcome. An echinocandin is first-line choice; fluconazole or amphotericin-B (lipid or liposomal) may be considered in certain circumstances.

Removing the source of infection is an essential part of therapy. Source control may include early abscess drainage, or the removal of central venous catheters.

Ophthalmological examination is generally recommended for patients with candidaemia.

Systemic candidiasis (acute disseminated candidiasis) is an infection of blood or other normally sterile sites (e.g., pleural and peritoneal fluid) with Candida species, usually in association with fever, hypotension, and/or leukocytosis. Candidaemia, or Candida bloodstream infection, is the most common form of systemic candidiasis. However, Candida organisms may be disseminated to multiple sites, notably retina, kidney, liver and spleen, bones, heart and the central nervous system. Chronic disseminated candidiasis usually implies a distinct form of disseminated infection, typically with involvement of liver and/or spleen in association with recovery from chemotherapy-induced neutropenia. 

Taxonomic changes have reclassified several species of Candida; for example, Candida auris has been reclassified as Candidozyma auris.[1]Kidd SE, Abdolrasouli A, Hagen F. Fungal nomenclature: managing change is the name of the game. Open Forum Infect Dis. 2023 Jan;10(1):ofac559. https://academic.oup.com/ofid/article/10/1/ofac559/6974385 http://www.ncbi.nlm.nih.gov/pubmed/36632423?tool=bestpractice.com ​ Within this topic, the traditional nomenclature is currently used, given that clinical adoption of the revised nomenclature is in its early stages.