Candidiasis
Invasive Candidiasis

Invasive Candidiasis

Treatment Guidelines

Positive blood cultures for yeast should not be regarded as a contaminant but should be treated as invasive disease

Empiric antifungal therapy should be considered in ICU patients with risk factors for invasive candidiasis and no other cause of fever (IDSA guidelines)

Species identification and susceptibility tests should be used to guide therapy

  • Based on β-D-glucan antigen and blood culture results
  • Both Negative: Antifungal therapy should be discontinued
  • One Positive: Recommended duration of therapy is 2 weeks

Laboratory Testing

Order β-D-glucan antigen test and blood cultures for patients started on empiric antifungal therapy (echinocandin or azole) with high suspicion of invasive candidiasis

  • Blood cultures have low sensitivity and slow growth; hence, a positive result may be detected late in course of disease
  • β-D-glucan antigen test has demonstrated to have high negative predictive value (poor specificity and false positivity)

More Information

  1. Kullberg VJ and Arendrup MC. Invasive Candidiasis. NEJM. 2015;373:1445-56.
  2. IDSA Management of Candidiasis Guideline: CID 2016;62(4):e1-50.