Fungemia: Difference between revisions
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'''Fungemia''' (also known as '''Candidemia''', '''Candedemia''', and '''Invasive Candidiasis''') is the presence of [[fungus|fungi]] or [[yeast]]s in the [[blood]]. It is most commonly seen in [[immunosuppressed]] or [[immunocompromised]] [[patient]]s with severe [[neutropenia]], [[oncology]] patients, or in patients with intravenous [[catheter]]s. Recently, it has been suggested the otherwise immunocompetent patients taking [[infliximab]] may be at a higher risk for fungemia. | '''Fungemia''' (also known as '''Candidemia''', '''Candedemia''', and '''Invasive Candidiasis''') is the presence of [[fungus|fungi]] or [[yeast]]s in the [[blood]]. It is most commonly seen in [[immunosuppressed]] or [[immunocompromised]] [[patient]]s with severe [[neutropenia]], [[oncology]] patients, or in patients with intravenous [[catheter]]s. Recently, it has been suggested the otherwise immunocompetent patients taking [[infliximab]] may be at a higher risk for fungemia. | ||
==Risk factors== | |||
The two most important risk factors are: | The two most important risk factors are: | ||
# Use of [[broad-spectrum antibiotic]]s | |||
# Colonization by fungi (see e.g. [[candidiasis]]) | |||
Other risk factors | Other risk factors include: | ||
* [[Dialysis]] | * [[Dialysis]] | ||
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* [[Burn (injury)|burn]]s | * [[Burn (injury)|burn]]s | ||
==Differential diagnosis of most common pathogens== | |||
The most commonly known [[pathogen]] is ''[[Candida albicans]]'', causing roughly 70% of fungemias, followed by ''[[Candida glabrata]]'' with 10%, and ''[[Aspergillus]]'' with 1%. However, the frequency of infection by ''T. glabrata'', ''[[Candida tropicalis]]'', ''[[Candida krusei|C. krusei]]'', and ''[[Candida parapsilosis|C. parapsilosis]]'' is increasing, especially when significant use of [[fluconazole]] is common. | The most commonly known [[pathogen]] is ''[[Candida albicans]]'', causing roughly 70% of fungemias, followed by ''[[Candida glabrata]]'' with 10%, and ''[[Aspergillus]]'' with 1%. However, the frequency of infection by ''T. glabrata'', ''[[Candida tropicalis]]'', ''[[Candida krusei|C. krusei]]'', and ''[[Candida parapsilosis|C. parapsilosis]]'' is increasing, especially when significant use of [[fluconazole]] is common. | ||
==Signs and symptoms== | |||
Symptoms can range from mild to extreme, often described as extreme [[flu]]-like symptoms. Pain, mental disorders, chronic [[fatigue (medical)|fatigue]], [[infections]], are a few of the long list of associated symptoms with Fungemia. | Symptoms can range from mild to extreme, often described as extreme [[flu]]-like symptoms. Pain, mental disorders, chronic [[fatigue (medical)|fatigue]], [[infections]], are a few of the long list of associated symptoms with Fungemia. | ||
==Diagnosis== | |||
The [[diagnosis]] is complicated, as routine [[blood culture]]s have poor sensitivity. | |||
==Treatment== | |||
Treatment involves use of [[antifungals]], e.g. [[fluconazole]] or [[amphotericin]]. | |||
== See also == | == See also == | ||
* [[Bacteremia]] | * [[Bacteremia]] | ||
Revision as of 18:32, 25 January 2009
| Fungemia | |
| ICD-9 | 117.9 |
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| MeSH | D016469 |
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Overview
Fungemia (also known as Candidemia, Candedemia, and Invasive Candidiasis) is the presence of fungi or yeasts in the blood. It is most commonly seen in immunosuppressed or immunocompromised patients with severe neutropenia, oncology patients, or in patients with intravenous catheters. Recently, it has been suggested the otherwise immunocompetent patients taking infliximab may be at a higher risk for fungemia.
Risk factors
The two most important risk factors are:
- Use of broad-spectrum antibiotics
- Colonization by fungi (see e.g. candidiasis)
Other risk factors include:
- Dialysis
- Diabetes
- Lowered intestinal flora
- Suppressed Immune system
- Central venous catheter
- High severity of illness
- Multiple abdominal surgeries
- Use of steroids
- burns
Differential diagnosis of most common pathogens
The most commonly known pathogen is Candida albicans, causing roughly 70% of fungemias, followed by Candida glabrata with 10%, and Aspergillus with 1%. However, the frequency of infection by T. glabrata, Candida tropicalis, C. krusei, and C. parapsilosis is increasing, especially when significant use of fluconazole is common.
Signs and symptoms
Symptoms can range from mild to extreme, often described as extreme flu-like symptoms. Pain, mental disorders, chronic fatigue, infections, are a few of the long list of associated symptoms with Fungemia.
Diagnosis
The diagnosis is complicated, as routine blood cultures have poor sensitivity.
Treatment
Treatment involves use of antifungals, e.g. fluconazole or amphotericin.