Resumo
Definição
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
- renal dialysis
- surgery
- parenteral nutrition
- use of immunosuppressants
- colonization at multiple sites
- intravenous drug use
Diagnostic investigations
1st investigations to order
- blood culture
- CBC
- ABG
- lactate levels
- coagulation studies
- renal function tests
- LFT
- serum glucose
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
Emerging tests
- polymerase chain reaction
Treatment algorithm
suspected diagnosis
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
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
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Diagnósticos diferenciais
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Mais Diagnósticos diferenciaisDiretrizes
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