Candidemische

Candidemische is a medical term used in some languages to describe candidaemia, the presence of Candida species in the bloodstream. It denotes an invasive fungal infection that can occur in hospitalized patients and may lead to sepsis if not promptly treated. The term candidaemia (or candidaemia) is more common in English, while candidemische functions as an adjectival form in other languages.

The condition arises when Candida organisms, which often colonize skin and mucosal surfaces, enter the bloodstream. This can occur via intravascular devices such as central venous catheters, after surgery, or in the setting of immunosuppression, neutropenia, prolonged antibiotic use, intensive care unit stay, diabetes, or parenteral nutrition. Species frequently implicated include Candida albicans, Candida glabrata, Candida parapsilosis, and Candida tropicalis; resistance patterns vary by species and geography.

Clinical features are often nonspecific and may include persistent fever despite broad-spectrum antibiotics, chills, hypotension, or signs of disseminated infection. Diagnosis relies on repeated blood cultures; non-culture tests such as beta-D-glucan assays or species-specific PCR can support but do not replace culture. Imaging and assessment for metastatic foci may be indicated in certain patients.

Management requires prompt antifungal therapy and removal of potentially infected devices when feasible. First-line treatment commonly involves an echinocandin (for example, caspofungin, micafungin, or anidulafungin), with fluconazole as an option in stable cases with susceptible isolates. Therapy typically continues for at least 14 days after clearance of the bloodstream and resolution of symptoms. Prognosis depends on host factors and timely treatment; candidemische carries substantial mortality in high-risk populations. Prevention focuses on infection control, catheter care, and antifungal stewardship.