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[Systemic candidiasis].

P Lelarge1, J Mariot

  • 1Département d'Urgence et de Réanimation, Hôpital Central, Nancy.

Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1992
PubMed
Summary
This summary is machine-generated.

Disseminated candidiasis, a serious fungal infection, affects immunocompromised patients, particularly those with surgical histories or prolonged intensive care. Early diagnosis and new treatments like fluconazole are crucial for improving outcomes.

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Candida infections are increasing in hospital patients with compromised cellular immunity.
  • Disseminated candidiasis is prevalent in surgical patients (GI, cardiac), transplant recipients, and those in intensive care.
  • High-risk groups include neonates, hematologic oncology patients, IV drug users, and AIDS patients.

Purpose of the Study:

  • To review the epidemiology, clinical presentation, diagnosis, and treatment of disseminated candidiasis.
  • To highlight the challenges in diagnosing systemic candidiasis versus colonization.
  • To discuss current and emerging therapeutic strategies.

Main Methods:

  • Review of existing literature on candidiasis.

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  • Analysis of clinical signs and diagnostic methods, including immunological tests.
  • Evaluation of antifungal treatment options.

    • Main Results:

    • Clinical signs are often non-specific, with secondary organ involvement varying by patient group.
    • Distinguishing invasive candidiasis from saprophytism requires careful interpretation of Candida isolation.
    • Immunological tests, particularly mannan detection, show promise, while antibody/metabolite tests are less conclusive.

    Conclusions:

    • Early recognition of accessible lesions and sterile site cultures are vital for diagnosis.
    • Amphotericin B with flucytosine remains standard, but newer azoles like fluconazole offer improved tolerability and efficacy.
    • Gut decontamination may reduce mortality in systemic candidiasis.