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Potentially life-threatening emergency
Disseminated candidiasis in Adult
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Potentially life-threatening emergency

Disseminated candidiasis in Adult

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

Synopsis

Disseminated candidiasis, also known as Candida septicemia, is a systemic infection of Candida species that can present with cutaneous findings in the debilitated or immunocompromised patient. Risk factors include prolonged systemic steroids or antibiotic administration, immunosuppressive medications in association with organ transplantation, human immunodeficiency virus (HIV) / AIDS, neoplastic disease, chemotherapy, hemodialysis, Foley or other catheterization, recent gastrointestinal surgery, or parenteral hyperalimentation. 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, and 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 gastrointestinal tract is the source of infection. Skin invasion from macerated intertriginous regions, intravenous lines, and intravenous 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 a rare emerging cause of candidemia that is notable for high rates of mortality and for drug resistance.

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: 02/01/2017
Last Updated: 10/11/2018
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Potentially life-threatening emergency
Disseminated candidiasis in Adult
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Disseminated candidiasis : Chills, Fever, Mental status alteration, Scattered many, Myalgia, Smooth papules, BP decreased, Pustules
Clinical image of Disseminated candidiasis
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