Rapid diagnosis of Candida sepsis in surgical patients

Systemic candidiasis, an increasingly common disease, is associated with an extremely high mortality. Because of toxicity associated with amphotericin B therapy, clinicians are reluctant to initiate therapy until the presence of candidiasis is conclusively demonstrated. Using culture methods, such proof may not be forthcoming or may be available only late in the course of the disease. During the last 17 months, a new antigen latex agglutination test for candidiasis has been evaluated. Results indicate that this new test allows early, accurate diagnosis of the disease. In 36 consecutive cases of culture-proven candidiasis in surgical patients, the test was found to be 94.4 per cent sensitive and 100 per cent specific. On the basis of these findings initiation of amphotericin B therapy in patients with a positive Candida antigen titer is recommended.