[Disseminated candidiasis. 23 cases collected in an intensive care unit]

Twenty-three cases of disseminated candidiasis (DC) were observed between 1965 and 1981. In 23 cases the DC was a complication of a preexisting disease process (16 abdominal surgery, 18 bacterial septicemia, 16 acute renal failure, 4 carcinoma) requiring polytherapy (23 antibiotherapy, 5 parenteral nutrition, 4 corticotherapy). The most frequent foci were ocular (6), peritoneal (5), renal (4), and pulmonary (3). Diagnosis was confirmed by blood culture (20), urine culture (12), culture of the catheter tip (7), isolation of candida from a localised focus and by anti candida antibodies in some patients. Nine patients were not treated and died; 14 patients were given antifungal agents: 6 died, three despite cure of DC. The recognition of favouring circumstances, early diagnosis and systematic treatment of all foci of candidiasis allow effective prophylaxis against DC; the last case in our series was in 1978.