Systemic candidiasis

Last reviewed: 23 Apr 2022
Last updated: 16 Nov 2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
More key diagnostic factors

Other diagnostic factors

  • tachycardia
  • tachypnoea
  • hypotension
  • poor capillary refill
  • acute mental confusion
  • decreased urine output
  • low oxygen saturation
  • rash
  • hepatosplenomegaly
  • hypothermia
Other diagnostic factors

Risk factors

  • use of central venous catheter
  • exposure to broad-spectrum antibiotics
  • colonisation at multiple sites
  • haemodialysis
  • surgery
  • parenteral nutrition
  • immunosuppressants (e.g., chemotherapy, systemic corticosteroids)
  • intravenous drug use
More risk factors

Diagnostic investigations

1st investigations to order

  • blood culture
  • FBC
  • ABG
  • lactate levels
  • coagulation studies
  • renal function tests
  • liver function test
  • serum glucose
More 1st investigations to order

Investigations to consider

  • beta 1,3 glucan
  • T2 magnetic resonance assay
  • tissue biopsy
More investigations to consider

Emerging tests

  • polymerase chain reaction
  • matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry

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

Jack D. Sobel, MD

Dean and Professor of Medicine

Wayne State University School of Medicine

Detroit

MI

Disclosures

JDS declares that he has no competing interests.

Sanjay G. Revankar, MD

Professor of Medicine

Division of Infectious Diseases

Wayne State University School of Medicine

Detroit

MI

Disclosures

SR has received grants for research from Astellas, Gilead, and Merck, and is involved in clinical trials for Cidara.

Peer reviewers

John Fisher, MD

Professor of Medicine

Department of Medicine

Medical College of Georgia

Augusta

GA

Disclosures

JF is an author of a number of references cited in this monograph. 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

Disclosures

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

Disclosures

MF declares that he has no competing interests.

  • Differentials

    • Bacterial sepsis
    • Drug-induced fever
    • Pulmonary embolism
    More Differentials
  • Guidelines

    • ECIL-6 guidelines for the treatment of invasive candidiasis, aspergillosis and mucormycosis in leukemia and hematopoietic stem cell transplant patients
    • Clinical practice guideline for the management of candidiasis
    More Guidelines
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