Systemic Candidasis

Question 1

candida can get into the blood via

Answer 1

long term CVC, or TPN

Remove all catheters early

Question 2

What evaluation must be done with anyone with candida in the blood?

Answer 2

ophthalmic examination (rule out candida endophthalmitis

Question 3

where is candidemia from?

Answer 3

common hospital acquired infection linked to TPN and CVC and seen in immunocompromised pts (neutropenia)

Question 4

what is the corner stone of treatment of Candidemia?

Answer 4

CVC removal - speeds up clearance of candidemia and reduces mortality rates. Remove when feasible Empiric antifungal tx- echinocandins like caspofungin are 1st line

Question 5

why do we like caspofungin or echinocandins for 1st line tx?

Answer 5

excellent coverage for most common infective species like Candida albicans, C glabrata, C tropicalis, C parasilosis, C krusei

Question 6

Why do we not use -azoles as 1st line tx for candidemia (candida in blood)?

Answer 6

fluconazole treats C albicans but not C glabrata or C krusei

Question 7

We don’t exchange CVC catheters via guidewire in candidemia infections because

Answer 7

Never exchange. Just take out CVC

put in a new line.

increased septic emboli risk and results in inoculation in new area. also can have inoculation of new catheter

Question 8

what does candida look like?

Answer 8

budding yeast

Question 9

candida pyelonephritis

Answer 9

form of invasive candidasis

be suspicious when there’s pyelonephritis that doesn’t respond to antibiotics and urine culture grows candida.

Risk factors are

broad sprectrum antibiotics,

uncontrolled DM2

history of recurrent UTIs

Question 10

Treatment of candida pyelonephritis:

Answer 10

treat with amphotericin B for total therapy duration of 10-14 days.