Invasive Candidiasis Causes, Symptoms, Diagnosis, Treatment, Prevention

Invasive Candidiasis Causes, Symptoms, Diagnosis, Treatment, Prevention


Definition of Invasive candidiasis

A fungal infection that occurs when Candida (a yeast-like fungus) enters the bloodstream and then spreads through the body. Candida is the fourth most common cause of bloodstream infection among hospitalized patients in the US. A survey found that candidemia (bloodstream infection with Candida) occurs in 8 of every 100,000 persons per year. Persons at high risk for candidemia include low-birth-weight babies, surgical patients, and those whose immune systems are deficient.

The symptoms of invasive candidiasis are not specific. Fever and chills that do not improve after antibiotic therapy are the most common symptoms. If the infection spreads to deep organs such as kidneys, liver, bones, muscles, joints, spleen, or eyes, additional specific symptoms may develop, which vary depending on the site of infection. If the infection does not respond to treatment, the patient's organs may fail and cause death.

Invasive candidiasis may result when a person's own Candida organisms, normally found in the digestive tract, enter the bloodstream. On rare occasions, it can also occur when medical equipment or devices become contaminated with Candida. In either case, the infection may spread throughout the body.

Invasive candidiasis is usually diagnosed by either culture of blood or tissue or by examining samples of infected tissue under the microscope. Invasive candidiasis is usually treated with an antifungal agent called amphotericin B that is given intravenously(IV) (in the vein) or it may be treated with the azole drugs taken by mouth or IV.

How common is invasive candidiasis and who can get it?


One form of invasive candidiasis, candidemia, is the fourth most common bloodstream infection among hospitalized patients in the United States.. A survey conducted at CDC found that candidemia occurs in 8 of every 100,000 persons per year. Persons at high risk for candidemia include low-birth-weight babies, surgical patients, and those whose immune systems are deficient.

Who Gets Invasive Candidiasis?


Candidemia (a bloodstream infection with Candida), is the fourth most common bloodstream infection among hospitalized patients in the United States. People at high risk for developing candidemia include:
  • Intensive care unit (ICU) patients
  • Surgical patients
  • Patients with a central venous catheter
  • People whose immune systems are weakened (such as people with HIV/AIDS)
  • Very low-birth-weight infants

What are the symptoms of invasive candidiasis?


The symptoms of invasive candidiasis are not specific. Fever and chills that do not improve after antibiotic therapy are the most common symptoms. If the infection spreads to deep organs such as kidneys, liver, bones, muscles, joints, spleen, or eyes, additional specific symptoms may develop, which vary depending on the site of infection. If the infection does not respond to treatment, the patient’s organs may fail and cause death.

How is invasive candidiasis transmitted?


Invasive candidiasis may result when a person’s own Candida organisms, normally found in the digestive tract, enter the bloodstream. On rare occasions, it can also occur when medical equipment or devices become contaminated with Candida. In either case, the infection may spread throughout the body.

How is invasive candidiasis diagnosed?


Invasive candidiasis is usually diagnosed by either culture of blood or tissue or by examining samples of infected tissue under the microscope.

Treatment & Outcomes of Invasive Candidiasis


Invasive candidiasis requires treatment with oral or intravenous (IV) antifungal medication for several weeks.  The type and duration of antifungal treatment will depend on patient-specific factors such as age, immune status, and severity of infection. Treatment of invasive candidiasis should include prompt removal of catheters.

Neonates with invasive candidiasis should be treated with amphotericin B for at least 3 weeks. For clinically stable children and adults, fluconazole or an echinocandin (caspofungin, micafungin, or anidulafungin) is the recommended form of therapy. In critically ill patients, an echinocandin or a lipid formulation of amphotericin B is recommended. Treatment should continue for 2 weeks after signs and symptoms of candidemia have resolved and the Candida yeasts have been cleared from the bloodstream.

How Can Invasive Candidiasis be Prevented?


Antifungal prophylaxis may be appropriate for some groups of people who are at high risk of developing candidemia, such as low-birth-weight infants.

  • Doctors and nurses can follow CDC-recommended infection control steps every time they work with a central line.
  • Patients and caregivers can ask if a central line is needed and, if so, how long it should stay in place. They can also make sure that healthcare professionals wash their hands before they care for the central line. Patients should speak up if the skin around the central line becomes sore or red, or if their bandages are wet or dirty. 
  • Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.