Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- febre
Other diagnostic factors
- taquicardia
- taquipneia
- hipotensão
- enchimento capilar lentificado
- confusão mental aguda
- débito urinário diminuído
- baixa saturação de oxigênio
- erupção cutânea
- hepatoesplenomegalia
- hipotermia
Risk factors
- uso de cateter venoso central
- exposição a antibióticos de amplo espectro
- hemodiálise
- cirurgia
- nutrição parenteral
- imunossupressores (por exemplo, quimioterapia, corticosteroides sistêmicos, imunossupressores biológicos e outros)
- colonização em múltiplos locais
- uso de substâncias por via intravenosa
Diagnostic tests
1st tests to order
- hemocultura
- Hemograma completo
- gasometria arterial
- níveis de lactato
- exames de coagulação
- testes de função renal
- teste da função hepática
- glicose sérica
Tests to consider
- 1,3-beta-D-glicano
- ensaio de ressonância magnética T2
- biópsia tecidual
Emerging tests
- reação em cadeia da polimerase
- espectrometria de massa por tempo de voo com ionização/dessorção a laser assistida por matriz (MALDI-TOF)
Treatment algorithm
suspeita diagnóstica
diagnóstico confirmado: pacientes não neutropênicos (sem complicações)
diagnóstico confirmado: pacientes neutropênicos (sem complicações)
diagnóstico confirmado: com complicações
Contributors
Authors
Brenda L. Tesini, MD
Assistant Professor
Infectious Diseases
Departments of Medicine and Pediatrics
University of Rochester Medical Center
Rochester
NY
Disclosures
BLT has received honoraria from Merck for educational contributions unrelated to this topic.
Acknowledgements
Dr Brenda L. Tesini 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.
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 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
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.
References
Key articles
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.Full text Abstract
Centers for Disease Control and Prevention. Candida auris: information for laboratorians and health professionals. Jul 2021 [internet publication].Full text
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.Full text Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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