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

Disseminated candidiasis in Child

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Contributors: Philip I. Song MD, Susan Burgin MD, Craig N. Burkhart MD, Dean Morrell MD
Other Resources UpToDate PubMed

Synopsis

Disseminated candidiasis, also known as invasive candidiasis, Candida septicemia, or systemic candidiasis, arises as a result of Candida species in the blood and is predominantly caused by Candida albicans species. Candida species on a blood culture should not be considered a contaminant. Systemic candidiasis varies in its severity and clinical presentation. It can range from a mild presentation with cutaneous manifestations to more widespread and disseminated disease involving multiple organs, sepsis, and shock. Systemic candidiasis is more common among immunosuppressed patients and chronically or critically ill children, in addition to patients with a defective or compromised skin barrier. Other risk factors include having a central venous catheter, hematologic malignancy, or stem-cell transplant, receiving parenteral nutrition, receiving hemodialysis, and being on broad-spectrum antibiotics.

Organ systems commonly affected include the kidneys, with over half of patients manifesting some form of renal involvement, which may include candiduria, hypertension, renal failure, abscess formation, or the development of fungal balls leading to obstruction and hydronephrosis. Central nervous system (CNS) involvement is also frequent, occurring in one-third of cases, and may result in abscess formation. Endophthalmitis is seen in almost half of all cases.

Cutaneous manifestations of systemic Candida infection include a generalized dermatitis, which may be followed by desquamation. Other common skin findings range from discrete pustules and erythematous or pink papules to nodules and necrotic skin. Macules may also be present. Chorioretinitis is characteristic.

Generalized symptoms include spiking fevers, chills, headache, hypotension, respiratory distress, blurred vision, and prostration. Myalgias, arthralgias, and osteoarthritis may be present. Pneumonia occurs in 70% of patients.

Systemic candidiasis is a serious illness that is associated with significant morbidity and mortality.

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: 03/23/2017
Copyright © 2019 VisualDx®. All rights reserved.
Potentially life-threatening emergency
Disseminated candidiasis in Child
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View all Images (9)
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Disseminated candidiasis : Chills, Fever, Mental status alteration, Scattered many, Myalgia, Smooth papules, BP decreased, Pustules
Clinical image of Disseminated candidiasis
Copyright © 2019 VisualDx®. All rights reserved.