- Risk factors for systemic candida include immunosuppression, intravascular catheters (TPN), broad spectrum antibiotics
- Infection is considered systemic once you have positive blood cultures
- Once you are concerned for systemic infection, make sure to get an Ophthalmology consult to rule out endophthalmitis!
- Start with an echinocandin for treatment unless you have a UTI, meningitis, or endophthalmitis in which cause you should use an azole medication
- If you have evidence of Candida glabrata then an azole may not work because there tends to be resistance
- If you have Candida glabrata meningitis, UTI, or endophthalmitis, you should start with amphotericin until you have susceptibilities
- Do not treat asymptomatic candiduria unless the patient is neutropenic or had recent urologic procedures done
The Chief Residents' Blog