Candida blood stream infection

Recommended total duration: 14 days from first negative blood culture after antifungals have been started, if no metastatic foci, and symptoms have resolved.

Risk factors include: GI surgery, diabetes mellitus, central vascular catheters, TPN, and urinary tract manipulation or surgery including stents.

For further information see SAPG guidance here. 

Required investigations

  • Blood cultures: every 48h until documented clearance of Candida from blood
  • Dilated fundoscopic examination: Preferably by an ophthalmologist, within 7 days of diagnosis
  • Other investigations are dictated by likely source of Candida, and metastatic spread to other sites. Correlate with patient symptoms.
  • HIV screen

Antimicrobial recommendations

All cases will be managed in conjunction with an infection specialist. Advice can be found here.

IV to oral switch

Consider if the following criteria are met:

  • Minimum of 5 days IV therapy
  • Clinically stable
  • Repeat blood culture negative
  • Isolate is susceptible to oral agent