Candidemia
Candidemia is a Candida yeast infection of the bloodstream. It is one of the more serious fungal infections seen in hospital settings, carrying a significant mortality risk if treatment is delayed. Unlike superficial fungal infections of the skin or mucous membranes, candidemia spreads through the blood and can seed organs including the heart, kidneys, and eyes.
Key points
- Unlike infections confined to the skin, this bloodstream infection can seed organs such as the heart, kidneys and eyes.
- It mostly develops in people whose immune defences are already weakened, such as by intensive care stays, central lines or recent abdominal surgery.
- Treatment relies on antifungal medicines given intravenously or by mouth, with voriconazole used where azole-susceptible strains are confirmed by testing.
Who is at risk
Candidemia almost always occurs in people whose defences are already compromised. Common risk factors include prolonged stays in intensive care, central venous catheters, broad-spectrum antibiotic use, recent abdominal surgery, and conditions that weaken immunity such as haematological cancers or uncontrolled diabetes. Rising rates of hospitalisation and increased use of invasive medical procedures have made candidemia an increasingly reported nosocomial infection.
How candidemia is treated
Treatment relies on antifungals given intravenously or orally, depending on the species of Candida identified and the patient’s clinical status. Voriconazole is active against most Candida species and is used in selected cases, particularly where azole-susceptible strains are confirmed. The choice of agent is guided by culture and sensitivity results, since resistance patterns vary by region.
Anyone suspected of having candidemia, persistent fever, chills, or signs of organ involvement despite antibiotic therapy, should be evaluated in a hospital without delay.