Highlights & Basics
- 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.
- Therapy should be started within 24 hours of diagnosis to improve outcome. An echinocandin is first-line choice; fluconazole may be considered in certain circumstances.
- Central venous catheters should be removed in non-neutropenic patients.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
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.[Abstract][Full Text]
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.[Abstract][Full Text]
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38. Garey KW, Rege M, Pai MP, et al. Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis. 2006 Jul 1;43(1):25-31.[Abstract]
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40. Patel GP, Simon D, Scheetz M, et al. The effect of time to antifungal therapy on mortality in Candidemia associated septic shock. Am J Ther. 2009 Nov-Dec;16(6):508-11.[Abstract]
41. Denning DW. Echinocandin antifungal drugs. Lancet. 2003 Oct 4;362(9390):1142-51.[Abstract]
42. Betts RF, Nucci M, Talwar D, et al; Caspofungin High-Dose Study Group. A Multicenter, double-blind trial of a high-dose caspofungin treatment regimen versus a standard caspofungin treatment regimen for adult patients with invasive candidiasis. Clin Infect Dis. 2009 Jun 15;48(12):1676-84.[Abstract]
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44. Andes DR, Safdar N, Baddley JW, et al. Impact of treatment strategy on outcomes in patients with candidemia and other forms of invasive candidiasis: a patient-level quantitative review of randomized trials. Clin Infect Dis. 2012 Apr;54(8):1110-22.[Abstract][Full Text]
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