|Invasive Candidiasis, A Hematogenous Dissemination of Candida|
What is Invasive Candidiasis?
Invasive candidiasis is an infection caused by a yeast (a type of fungus) called Candida. Unlike Candida infections in the mouth and throat (also called "thrush") or vaginal "yeast infections", which are localized to one part of the body, invasive candidiasis is a serious infection that can affect the blood, heart, brain, eyes, bones, or other parts of the body.
Candida normally lives in the gastrointestinal tract and on skin without causing any problems. However, in certain patients who are at risk, Candida can enter the bloodstream and cause an infection. A Candida bloodstream infection, which is the most common form of invasive candidiasis, is called candidemia. Candidemia is one of the most common causes of bloodstream infections in hospitalized patients and it often results in long hospital stays, high medical costs and poor outcomes.
Invasive candidiasis can be treated with antifungal medication. Antifungal medication is often given to prevent the infection from developing in certain patient groups.
Symptoms of Invasive Candidiasis
Fever and chills are the most common symptoms of invasive candidiasis. People who develop invasive candidiasis are often already sick from other medical conditions, so it can be difficult to know which symptoms are related to a Candida infection. However, the most common symptoms of invasive candidiasis are fever and chills that don't improve after antibiotic treatment for suspected bacterial infections. Other symptoms can develop if the infection spreads to other parts of the body, such as the heart, brain, eyes, bones or joints.
Invasive Candidiasis Risk and Prevention
Who gets Invasive Candidiasis?
Most cases of invasive candidiasis occur in people who have recently been admitted to a hospital or been in contact with other healthcare settings such as nursing homes. People who are at high risk for developing invasive candidiasis include:
• Patients who have a central venous catheterDiagnosis and Testing for Invasive Candidiasis
• Patients in the intensive care unit (ICU)
• People who have weakened immune systems (for example, people who have had an organ transplant, have HIV/AIDS, or are on cancer chemotherapy)
• People who have taken broad-spectrum antibiotics
• People who have a very low neutrophil (a type of white blood cell) count (neutropenia)
• People who have kidney failure or are on hemodialysis
• Patients who have had surgery, especially gastrointestinal surgery
• Patients who have diabetes
|Invasive Candidiasis Causes|
How is invasive candidiasis diagnosed?
Healthcare providers rely on your medical history, symptoms, physical examinations, and laboratory tests to diagnose invasive candidiasis. The most common way that healthcare providers test for invasive candidiasis is by taking a blood sample and sending it to a laboratory to see if it will grow Candida in a culture.
How long will it take to get my test results?
Results from a blood test will usually be available in a few days.
Sources of Invasive Candidiasis
Candida lives in and on the body. Candida, the fungus that causes invasive candidiasis, normally lives in the gastrointestinal tract and on skin without causing any problems. In people who are at higher risk for the infection, invasive candidiasis may occur when a person's own Candida yeasts enter the bloodstream, for example, where an intravenous (IV) catheter was inserted or during surgery.
Medical equipment or devices, particularly intravenous catheters, can also become contaminated with Candida and allow the fungus to enter the bloodstream. Healthcare workers can also carry Candida on their hands. There have been a few outbreaks of candidemia linked to healthcare workers' hands, so hand hygiene in healthcare settings is important for preventing the spread of infections.
Types of Candida
There are over 150 species of Candida, but only about 15 of these are known to cause infections. The most common species that cause infections are C. albicans, C. glabrata, C. parapsilosis, C. tropicalis and C. krusei.
|Risk for Invasive Candidiasis is a Continuum|
Treatment for Invasive Candidiasis
How is invasive candidiasis treated?
The specific type and dose of antifungal medication used to treat invasive candidiasis usually depends on the patient's age, immune status, and location and severity of the infection. For most adults, the initial recommended antifungal treatment is an echinocandin (caspofungin, micafungin, or anidulafungin) given through the vein (intravenous or IV). Fluconazole, amphotericin B, and other antifungal medications may also be appropriate in certain situations.
How long does the treatment last?
For candidemia, treatment should continue for 2 weeks after signs and symptoms have resolved and Candida yeasts are no longer in the bloodstream. Other forms of invasive candidiasis, such as infections in the bones, joints, heart, or central nervous system, usually need to be treated for a longer period of time.