Candidemia

Candidemia is a form of infection characterized by the presence of Candida species in the blood. It is a type of invasive candidiasis, which is a serious infection that can affect the blood, heart, brain, eyes, bones, and other parts of the body. Candidemia is most commonly seen in hospitalized patients, particularly those with weakened immune systems, such as those undergoing chemotherapy, organ transplant recipients, or individuals with HIV/AIDS.

Causes

Candidemia is primarily caused by the yeast-like fungus Candida albicans, although other Candida species, such as Candida glabrata, Candida parapsilosis, and Candida tropicalis, can also be responsible. These fungi are normally present on the skin and within the gut flora without causing disease; however, they can become pathogenic under certain conditions, such as when the normal balance of microorganisms is disrupted or the immune system is compromised.

Risk Factors

Several factors can increase the risk of developing candidemia, including:

• Prolonged use of antibiotics that disrupt normal flora
• Use of central venous catheters
• Surgery, especially abdominal surgery
• Neutropenia (low white blood cell count)
• Diabetes mellitus
• Kidney failure or dialysis
• Prolonged hospitalization, particularly in intensive care units (ICU)

Symptoms

The symptoms of candidemia can be nonspecific and vary widely, but they may include:

• Fever and chills that do not improve with antibiotic treatment
• Hypotension (low blood pressure)
• Tachycardia (rapid heart rate)
• Confusion or changes in mental status

Diagnosis

Diagnosis of candidemia involves the detection of Candida species in the blood. This is typically done through blood cultures, which can identify the specific type of Candida causing the infection. Other tests, such as biomarkers like beta-D-glucan or mannan antigen, may also assist in the diagnosis.

Treatment

The treatment of candidemia usually involves antifungal medications. The choice of antifungal depends on the species of Candida and its susceptibility profile. Commonly used antifungals include:

• Fluconazole
• Echinocandins (e.g., caspofungin, micafungin, anidulafungin)
• Amphotericin B

Treatment duration can vary but typically continues until all signs and symptoms of infection have resolved, and blood cultures have been negative for a specified period.

Prevention

Preventive measures for candidemia focus on minimizing risk factors when possible. This includes careful management of antibiotics, maintaining strict infection control practices, and the appropriate use of prophylactic antifungal medications in high-risk patients.

See Also

• Invasive candidiasis
• Fungal infection
• Sepsis