[Fungal sepsis and DIC in surgical patients]

Of 53 surgical cases complicated with severe infection who were admitted to The Second Department of Surgery of Osaka University Hospital between 1975 and 1982, 9 cases were suffered from sepsis with positive blood culture for Candida albicans. All cases developed DIC and subsequent multiple organ failures (MOF), which was likely triggered by fungal sepsis because of the absence of any coexisting pathogens. Fungal sepsis was developed following a long term massive antimicrobial therapy in 7 cases and also following a long term steroid therapy in 1 cases. No apparent portal of fungal entry was confirmed except 3 cases with a positive fungal culture for central venous catheter. Six cases were fatal without improvement of DIC or MOF, to whom no early administration of antifungal agents was performed due to lack of recognition of fungal virulence. However, 3 cases were completely recovered from DIC and MOF by treatment with antifungal agents and anticoagulants. These observations suggest that DIC due to fungal sepsis may be eradicated by recognition of fungal virulence and by appropriate treatment with antifungal agents and anticoagulants.