Candidemia- The eyes, kidney, liver and brain

Candida is the single most important cause of fungal infections worldwide. In the U.S., Candida is the 4th most common cause of bloodstream infection that can develop while you are in a hospital (also called "nosocomial" infection or hospital acquired infection). There are 17 different species of Candida. Of these, Candida albicans (C. albicans), C. glabrata, C. parapsilosis and C. tropicalis are the most common species.




Where in my body can I get a Candida infection?


Candida infection can happen in almost any part of your body. Usually it develops on mucous membranes (in the mouth, genitals etc.) but the infection can also be in your bloodstream. When Candida is in your blood stream, the condition is called Candidemia. Candida infection can spread from your blood stream to other parts of your body (such as your eyes, kidney, liver and brain). If this happens, it is called Invasive Candidemia. People who are healthy do not usually get Candidemia. Healthy people however, may get a Candida infection in their mouth (called thrush) from certain drugs such as inhaled corticosteroids used to treat asthma and COPD. If you are very ill or have a weakened immune system (for example from chemotherapy or an organ transplant), are diabetic, receive corticosteroids, broad spectrum antibiotics or have a central venous catheter in place, you are predisposed to develop Candidemia. A central venous catheter is a tube that is inserted in one of the major blood vessels leading to the heart and is used to give you medications, chemotherapy, or nutritional supplements. (see ATS Patient Series at http://patients.thoracic.org/information-series/en/resources/central-venous-catheter.pdf for information on central venous catheters).




How can I get Candidemia?


In the hospital, 40% of bloodstream infections are caused by the fungus Candida. Most often, Candidemia develops within a week of being admitted to an intensive care unit (ICU) if you also have a central venous catheter, get kidney dialysis, have major surgery, have a low white blood count, or if you are getting broad spectrum antibiotics, intravenous steroids or medications to depress your immune system. You can also get Candidemia outside of the hospital if you are sent home from the hospital with a central venous catheter or if you are on cancer chemotherapy. Chemotherapy weakens your immune system and can put you at risk for common infections, like the cold or flu, or less common infections, like Candidemia or other fungal infections. Candida species can also enter the bloodstream alongside a catheter in your vein or artery, at the area where the catheter enters through the skin. Although Candida infections of the mucosal surfaces (mouth and esophagus) are usually easy to treat, treatment of Candidemia can be challenging, especially when the infection has spread to other organs (eye, brain or kidneys) and if there is a central venous catheter in place.
What are the signs and symptoms of Candidemia?


Signs and symptoms of Candida infection
Am J Respir Crit Care Med Vol. 185, P3-4, 2012 • Online Version Updated October 2013 www.thoracic.org



ATS Patient Education Series © 2012 American Thoracic Society