Fungemia

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Candidemia
)

Fungemia
Other namesFungaemia
Infectious disease

Fungemia is the presence of

immunocompromised patients with severe neutropenia, cancer patients, or in patients with intravenous catheters. It has been suggested that otherwise immunocompetent patients taking infliximab
may also be at a higher risk.

Diagnosis is difficult, as routine blood cultures have poor sensitivity.[2]

Signs and symptoms

Symptoms can range from mild to extreme—often described as extreme

infections. Skin infections can include persistent or non-healing wounds and lesions, sweating, itching, and unusual discharge or drainage.[citation needed
]

Risk factors

Other risk factors are:

Pathogens

The most commonly known

C. krusei and C. parapsilosis is increasing, perhaps because significant use of fluconazole is common or due to increase in antibiotic use.[citation needed
]

Candida auris is an emerging multidrug-resistant (MDR) yeast that can cause invasive infections and is associated with high mortality. It was first described in 2009 after being isolated from external ear discharge of a patient in Japan. Since the 2009 report, C. auris infections, specifically fungemia, have been reported from South Korea, India, South Africa, and Kuwait. Although published reports are not available, C. auris has also been identified in Colombia, Venezuela, Pakistan, and the United Kingdom.[4]

In a single reported instance, Psilocybe cubensis was reported to have been cultured from a case of fungemia in which an individual self-injected an underprocessed decoction of fungal matter.[5] The patient, who had been suffering from mild depression, attempted to self-medicate with the mushrooms but was frustrated by the lag time between eating the mushrooms and experiencing the psychedelic effects. In an attempt to bypass this, the patient boiled and filtered the mushrooms into a 'mushroom tea' which was then administered by injection. The patient had multiple organ failure, but this was successfully reversed and the infection treated with antifungal drugs.[6] Two other examples of fungemia as a result of injecting fungal matter in this way have been described in medical literature, both dating to 1985.[7]

Diagnosis

The gold standard for the diagnosis of invasive candidiasis and candidemia is a positive culture. Blood cultures should be obtained in all patients with suspected candidemia.[8]

Treatment

Neutropenic vs non-neutropenic candidemia is treated differently.[9]

An intravenous echinocandin such as anidulafungin, caspofungin or micafungin is recommended as first-line therapy for fungemia, specifically candidemia.[9] Oral or intravenous fluconazole is an acceptable alternative.[9] The lipid formulation amphotericin B is a reasonable alternative if there is limited antifungal availability, antifungal resistance, or antifungal intolerance.[9]

See also

References

  1. ^ "Statistics". Invasive Candidiasis. United States: Centers for Disease Control and Prevention. 13 November 2019. Retrieved 24 December 2019.
  2. PMID 23315320
    .
  3. .
  4. ^ "Clinical Alert to U.S. Healthcare Facilities – June 2016 | Candida auris | Fungal Diseases | CDC". 24 January 2019.
  5. PII S266729602030015X.[unreliable source?
    ]
  6. ^ "Psychedelic Mushrooms Grew in a Man's Veins After He Injected Them". Gizmodo. 12 January 2021. Retrieved 26 January 2021.
  7. ^ "Man Injects Psilocybin Mushrooms and They Grow in His Veins | Mysterious Universe". mysteriousuniverse.org. Retrieved 26 January 2021.
  8. ^ "UpToDate". www.uptodate.com. Retrieved 20 May 2022.
  9. ^
    PMID 26810419
    .

External links