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Potentially life-threatening emergency
Disseminated candidiasis in Adult
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Other Resources UpToDate PubMed
Potentially life-threatening emergency

Disseminated candidiasis in Adult

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Contributors: Philip I. Song MD, Susan Burgin MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

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Synopsis

Disseminated candidiasis : Chills, Fever, Scattered many, Myalgia, Smooth papules
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.

Codes

ICD10CM:
B37.7 – Candidal sepsis

SNOMEDCT:
70572005 – Disseminated candidiasis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:03/22/2023
Last Updated:03/23/2023
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Potentially life-threatening emergency
Disseminated candidiasis in Adult
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A medical illustration showing key findings of Disseminated candidiasis : Chills, Fever, Scattered many, Myalgia, Smooth papules
Clinical image of Disseminated candidiasis - imageId=186211. Click to open in gallery. caption: 'A cluster of red papules, some with overlying pustules and others with central early crusts, on the foot of a patient with end stage renal disease.'
A cluster of red papules, some with overlying pustules and others with central early crusts, on the foot of a patient with end stage renal disease.

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