Experience with invasive Candida infections
Hanasoge Girishkumar, Arshad M Yousuf, Jayant Chivate, Edward Geisler
Department of
Surgery, Bronx-Lebanon Hospital Center, Bronx, NY 10457, USA
Correspondence to: Saundra King, Coordinator, Department of Surgery, Bronx-Lebanon Hospital Center, 1650 Selwyn Avenue, Suite 4A, Bronx, NY 10457, USA
Accepted 2 November
1998
Between January and July 1995, 227 patients at the
Bronx-Lebanon Hospital Center had positive fungal cultures.
Candida spp were the most common fungi
isolated. Forty-three patients with invasive disease, as indicated by
fungus-positive blood cultures, became the focus of our study.
C albicans caused fungaemia in 21 patients
(49%). Twenty-eight patients (65%) were less than 50 years of age;
three were neonates. The most common presenting symptoms were fever,
chills, and weakness (20 patients, 47%). Thirty patients died, giving
a mortality rate of 70%. The patients who died stayed in the hospital
an average of 49 days.
The highest mortality occurred among patients who became bacteraemic
before or at the same time they became candidaemic (24 of 26 patients)
or who were receiving broad-spectrum antibiotics (20 of 26 patients).
We also found high mortality rates from invasive fungal infection among
patients with HIV infection, a central venous catheter, and liver,
renal, or respiratory failure. We did not find any increase in the
incidence of invasive fungal infection or mortality among leukopenic or
diabetic patients.
Keywords: Candida; invasive infection; risk factors
© 1999 by The Fellowship of Postgraduate Medicine
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