fungal infection 2 Flashcards
what is the morbidity and mortality rate of disseminated candidiasis
30-60%
what are the 3 distinct presentations of disseminated candidiasis (the first of these contains 5)
- acute onset of fever, tachycardia, tachypnea, chills and hypotension
- intermittent fevers and are only ill when febrile
- manifest progressive deterioration of their conditions with or without fever
where are lab diagnosis of candidiasis often cultured from in and potentially infected patients
urine and respiratory tract
what drugs work best for C. glabrata
echinocandins (ampho too, but can have intermediate resistance)
what is the difference in candiaisis and candidemia
candidiasis = spreading infection
candidemia = bloodstream infection
treat the same
what is primary therapy for candidiasis/ candidemia in nonneutropenic adults
fluconazole or echinocandin
what is primary therapy for candidiasis/ candidemia in neutropenic adults
echinocandin or lipid formulation of amphotericin
what is primary therapy for chronic disseminated candidiasis
fluconazole or amphotericin (for several weeks, followed by transition to fluconazole)
what should be chosen for moderately ill to severely ill candidiasis/ candidemia patients, or patients with recent azole exposure
echinocandin
for chronic dissimenated candidiasis. what should be initiated in stable patients
fluconazole
for chronic dissimenated candidiasis. what should be initiated in severe patients
amphotericin for a couple weeks
If someone is on empiric therapy, candidiasis should be assumed after how long a period of antibiotic therapy
4 days; sooner if risk factors present
what is the minimum treatment duration for candidiasis
14 days after first negative culture
what should be done with pt.s with IV lines who are determined to have candidiasis/ candidemia
remove any IV catheters
all patients with candidemia need what non pharm monitoring? what is this looking for
eye exam
to rule out candida endophthalmitis
