Hematogenous Candidiasis (Candidemia) - Fungal Infection

Question 1

What clinical presentation often occurs with candidemia?

Answer 1

• Acute onset fevers
• Tachypnea
• Tachycardia

Question 2

(T/F) - Intermittent fevers and are only ill when febrile

Answer 2

TRUE

Question 3

(T/F) - Progressive deterioration with or without fevers

Answer 3

TRUE

Question 4

How can candidemia diagnosis be confirmed?

Answer 4

Actually, no reliability lab test can confirm disseminated Candida infection

Question 5

However, what is recommended for diagnosis of candidemia?

Answer 5

• Blood cultures

- Susceptibility testing

Question 6

How are patients with less critically ill and no recent azole exposure with candidemia who are nonneutropenic treated?

Answer 6

• Echinocandin 800 mg x 1 day THEN 400 mg QD OR
• Fluconazole 800 mg x 1 day THEN 400 mg QD
  Duration of 14 days after 1st negative blood culture test

Question 7

How are patients with moderately severe to severe illness candidemia who are nonneutropenic treated?

Answer 7

Echinocandins

Duration of 14 days after 1st negative blood culture test

Question 8

How are patients who are neutropenic with candidemia treated?

Answer 8

Echinocandins

Duration of 14 days after 1st negative blood culture test

Question 9

What does neutropenic mean?

Answer 9

Cancer patients, receiving chemo

Question 10

Is prophylaxis recommended in candidemia patients?

Answer 10

Only in some patients

Question 11

Which patients are recommended for prophylaxis of candidemia?

Answer 11

• Solid-organ transplant recipients
• ICU patients in an ICU with high-incidence of invasive candidiasis
• Chemotherapy-induced neutropenia
• Stem cell transplant recipients with neutropenia

Question 12

What treatment option should be recommended in pregnant patients presenting candidemia?

Answer 12

Systemic amphotericin B