Fungemia
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Fungemia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Fungemia On the Web |
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American Roentgen Ray Society Images of Fungemia |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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.