Questions: What are the clinical settings and risk factors associated with Candida infections?
Answer:
- Chronic mucocutaneous infections: defects in T-lymphocyte immunity, congenital (e.g., chronic mucocutaneous candidiasis) or acquired (e.g., AIDS)
- Deeply invasive, disseminated infections: peripheral neutrophil count < 500/mm3; mucosal barrier breakdown (burn, cytotoxic agents, GI surgery, IV catheter sites); candidal overgrowth (broad-spectrum antibiotics)
- Colonization of a catheter, with fever: indwelling catheter
The difference between the first two categories may be difficult to distinguish clinically; if there is doubt, the patient should be treated for disseminated disease.
Reference: Pappas PG, et al: Guidelines for the treatment of candidiasis. Clin Infect Dis 38:161-189, 2004.