Fungemia

Fungemia
Classification and external resources
ICD-9	117.9
MeSH	D016469

Fungemia is the presence of fungi or yeasts in the blood. It is most commonly caused by Candida species (also known as Candidemia, Candedemia, and Invasive Candidiasis), but can be caused by other fungi as well, including Saccharomyces, Aspergillus and Cryptococcus. It is most commonly seen in immunosuppressed or immunocompromised patients with severe neutropenia, oncology patients, or in patients with intravenous catheters. Recently, it has been suggested the otherwise immunocompetent patients taking infliximab may be at a higher risk for fungemia.

The diagnosis is complicated, as routine blood cultures have poor sensitivity.

Treatment

Treatment involves use of antifungals, e.g. fluconazole or amphotericin.

Risk factors

The three most important risk factors are:

• Use of broad-spectrum antibiotics
• Presence of mercury (used in amalgam fillings) and other heavy metals.
• Colonization by fungi (see e.g. candidiasis)

Other risk factors are:

• Dialysis
• Diabetes
• Lowered intestinal flora
• Suppressed Immune system
• Use of yeast probiotics
• Central venous catheter
• High severity of illness
• Multiple abdominal surgeries
• Use of steroids
• burns

Pathogens

The most commonly known pathogen is Candida albicans, causing roughly 70% of fungemias, followed by Candida glabrata with 10%, Aspergillus with 1% and Saccharomyces as the fourth most common.^{[citation needed]} However, the frequency of infection by C. glabrata, Saccharomyces boulardii, Candida tropicalis, C. krusei and C. parapsilosis is increasing, perhaps because significant use of fluconazole is common or due to increase in antibiotic use.

Symptoms

Symptoms can range from mild to extreme, often described as extreme flu-like symptoms. Pain, mental disorders, chronic fatigue, infections, are a few of the long list of associated symptoms with Fungemia. Skin infections can include persistent or unhealing wounds and lesions, sweating, itching, unusual discharge or drainage and more.

See also

• Bacteremia
• Candidiasis
• Mycosis

External links

• Treatment of fungal infections
• Candidiasis: Overview and Full Index
• Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009;48:503-53.