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Systemic candidiasis

Última revisão: 21 Sep 2025
Última atualização: 10 Sep 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • fever
Detalhes completos

Outros fatores diagnósticos

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

Fatores de risco

  • 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
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • blood culture
  • CBC
  • ABG
  • lactate levels
  • coagulation studies
  • renal function tests
  • LFT
  • serum glucose
Detalhes completos

Investigações a serem consideradas

  • 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
Detalhes completos

Novos exames

  • polymerase chain reaction

Algoritmo de tratamento

Inicial

suspected diagnosis

AGUDA

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

Declarações

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

Declarações

RZ declares that she has no competing interests.

Agradecimentos

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.

Declarações

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

Раскрытие информации

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

Раскрытие информации

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

Раскрытие информации

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.

Список литературы

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Основные статьи

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.Полный текст  Аннотация

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

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.Полный текст  Аннотация

Статьи, указанные как источники

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