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SOURCE

Source: Carver PL. Invasive fungal infections. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861&sectionid=146073167. Accessed March 14, 2017.

DEFINITION

  • Yeasts that exist primarily as small, unicellular, thin-walled, ovoid cells that reproduce by budding.

ETIOLOGY

  • Eight species of Candida regarded as clinically important pathogens in human disease: C. albicans, C. tropicalis, C. parapsilosis, C. krusei, C. stellatoidea, C. guilliermondii, C. lusitaniae, and C. glabrata

PATHOPHYSIOLOGY

  • Generally acquired via the GI tract, although organisms may also enter bloodstream via indwelling IV catheters.

EPIDEMIOLOGY

  • Incidence of fungal infections caused by Candida species has increased substantially in past three decades.

    • Fourth most common cause of bloodstream infections in ICU patients.

PREVENTION

  • Antifungal prophylaxis with fluconazole in:

    • Febrile patients with neutropenia unresponsive to antibiotics.

    • Patients undergoing hematopoietic stem cell transplantation.

RISK FACTORS

IDSA candidiasis guideline-defined risk factors (Table 1):1

  • Severity of illness.

  • Broad spectrum antibiotics.

  • Recent major surgery.

  • Abdominal surgery.

  • Necrotizing pancreatitis.

  • Dialysis.

  • Parenteral nutrition.

  • Corticosteroids.

  • Use of CVCs.

  • Gastrointestinal perforation.

  • Anastomotic leaks.

TABLE 1.abRisk Factors for Invasive Candidiasis

CLINICAL PRESENTATION

SIGNS ...

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