Disseminated candidiasis, also known as Candida septicemia, is a systemic infection of Candida species that can present in the debilitated or immunocompromised patient. Risk factors include prolonged systemic steroids or antibiotic administration, immunosuppressive medications in association with organ transplantation, HIV / AIDS, neoplastic disease, chemotherapy, hemodialysis, Foley or vascular catheters, recent gastrointestinal (GI) surgery, and parenteral hyperalimentation as well as injection drug use. Systemic symptoms can include persistent high-grade fevers, chills, hypotension, myalgias, arthralgias, and bone pain. Candidal sepsis is often a near-terminal event, and patients with underlying graft-versus-host disease, cardiovascular compromise, or respiratory distress have a worse prognosis.

Systemic involvement can include acute candidal pyelonephritis, central nervous system (CNS) candidiasis, cardiovascular impairment, respiratory distress, altered consciousness, and severe diarrhea. Thrush is often present in the oropharynx in sepsis, but the presence of thrush in HIV-infected patients does not imply sepsis.

In most cases of Candida sepsis, the individual's own GI tract is the source of infection. Skin invasion from macerated intertriginous regions, intravenous (IV) lines, and IV drug abuse are other potential sources. Nosocomial infection with some Candida species (eg, Candida auris) has been associated with prolonged use of axillary temperature monitors. The vast majority of invasive candidiasis is caused by Candida albicans, Candida glabrata, Candida tropicalis, Candida parapsilosis, and Candida krusei. Candida albicans is the usual species, but C glabrata is often seen, and C tropicalis is often implicated in leukemic patients.

Candida auris is an emerging cause of candidemia that is notable for high rates of mortality and for drug resistance. See below and the US Centers for Disease Control and Prevention (CDC) Information for Laboratorians and Health Professionals for more detailed information.