1/5. Polymicrobial candidaemia revealed by peripheral blood smear and chromogenic medium.Candida spp are the fourth most common group of nosocomial pathogens isolated from patients on medical, surgical, and intensive care wards. Polymicrobial candidaemia has rarely been described. The diagnosis of candidaemia from peripheral blood smears has not been widely reported. This report describes the case of a young woman suffering from Ewing's sarcoma who developed a syndrome of septic shock. Deep fungal infection was diagnosed from a systematic peripheral blood smear and yeasts were isolated within 24 hours. A subculture on CHROMagar Candida allowed the differentiation and presumptive identification of candida tropicalis and Candida krusei. Species identification was confirmed by the ID 32C system. This report underlines the usefulness of peripheral blood smears in the diagnosis of fulminant deep fungal infections, and of a differential isolation medium in the rapid presumptive identification of clinically important yeast species from clinical samples. This medium is particularly useful for the detection of mixed fungal infections, allowing early and better adapted antifungal treatment.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
2/5. Nosocomial infective endocarditis in critically ill patients: a report of three cases and review of the literature.Nosocomial infective endocarditis (NIE) is a relatively uncommon but nevertheless a serious complication affecting critically ill hospitalized patients who are frequently exposed to life-saving invasive procedures. We report three cases of NIE in a tertiary-care hospital encountered during a period of two years. The first case developed in a 50% burn-injured patient; the second in a liver transplant recipient; and the third in a renal transplant recipient. All patients met indications for cardiac surgical intervention, however, the patient who had received a liver transplant (case 2) was considered a poor candidate and unfit for surgery; she subsequently died. The other two patients underwent open-heart surgery. The burns patient (case 1) survived; conversely, the renal transplant recipient (case 3) died postoperatively. We have reviewed the literature concerning NIE in critically ill patients and describe the epidemiology, microbiology and clinical features of this uncommon infection and comment on its diagnosis and management.- - - - - - - - - - ranking = 0.16666666666667keywords = candida (Clic here for more details about this article) |
3/5. survival of candida sepsis in extracorporeal membrane oxygenation.OBJECTIVE: To report the survival of fungal sepsis in extracorporeal membrane oxygenation. DESIGN: Single case report. SETTING: Tertiary referral children's hospital pediatric intensive care unit. patients: A single case report of an infant with congenital heart disease who developed candida sepsis while supported postoperatively with extracorporeal membrane oxygenation. RESULTS: This infant survived a prolonged episode of candidemia after repair of congenital heart disease, which required extracorporeal membrane oxygenation support. The patient has no identified sequelae at 6-month follow-up and continues on long-term fluconazole therapy for candida endocarditis. CONCLUSIONS: candidemia, particularly candida albicans species, may not be a contraindication for extracorporeal membrane oxygenation support. With antifungal therapy and adequate inotropic use to counter the effects of septicemia, survival can be maintained until the patient adequately recovers, allowing decannulation, removal of all catheters, and eventual bloodstream sterility.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
4/5. Application of microsatellite typing for the investigation of a cluster of cases of candida albicans candidaemia.A cluster of cases of candida albicans candidaemia in a surgical intensive care unit was investigated. The probability of such a cluster during a single month was highly significant compared with the frequency of candidaemia in the previous year. A molecular typing method, based on length analysis of three (EF3, CDC3, HIS3) microsatellite-containing regions, was used to investigate isolates from patients in and outside the ward. This demonstrated the involvement of different strains, indicating the absence of cross-transmission among patients. Results of microsatellite typing can be obtained almost in real-time, which is particularly useful in an outbreak context.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
5/5. Failure of therapy with fluconazole for candidal endophthalmitis.The incidence of candidemia and its complications, such as endophthalmitis, has measurably increased in recent years. However, the optimal method of treatment of hematogenous candidal infection remains a controversial issue. Traditional therapy with amphotericin b is associated with well-known adverse reactions. Many clinicians therefore prefer to use fluconazole, which is administered orally and is relatively less toxic. We recently observed a patient with candidal sepsis in whom blinding endophthalmitis developed despite aggressive and lengthy therapy with fluconazole. This grave clinical outcome and the data derived from experimental models of ocular candidal infection suggest that empirical usage of fluconazole may not be warranted in cases of disseminated candidiasis potentially complicated by endophthalmitis.- - - - - - - - - - ranking = 1.1666666666667keywords = candida (Clic here for more details about this article) |