Rare Gastroenterology News

Disease Profile

Systemic candidiasis

Prevalence
Prevalence estimates on Rare Medical Network websites are calculated based on data available from numerous sources, including US and European government statistics, the NIH, Orphanet, and published epidemiologic studies. Rare disease population data is recognized to be highly variable, and based on a wide variety of source data and methodologies, so the prevalence data on this site should be assumed to be estimated and cannot be considered to be absolutely correct.

Unknown

Age of onset

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ICD-10

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Inheritance

Autosomal dominant A pathogenic variant in only one gene copy in each cell is sufficient to cause an autosomal dominant disease

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Autosomal recessive Pathogenic variants in both copies of each gene of the chromosome are needed to cause an autosomal recessive disease and observe the mutant phenotype

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X-linked
dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.

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X-linked
recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder

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Mitochondrial or multigenic Mitochondrial genetic disorders can be caused by changes (mutations) in either the mitochondrial DNA or nuclear DNA that lead to dysfunction of the mitochondria and inadequate production of energy.

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Multigenic or multifactor Inheritance involving many factors, of which at least one is genetic but none is of overwhelming importance, as in the causation of a disease by multiple genetic and environmental factors.

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Not applicable

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Other names (AKA)

Systemic candida infections; Invasive Candidiasis

Summary

Systemic candidiasis includes a spectrum of yeast infections caused by different species (types) of Candida.[1] It is a serious infection that can affect the blood, heart, brain, eyes, bones, or other parts of the body.[2] Although there are over 200 species of Candida, five different species of Candida cause 90% of systemic candidiasis.[1][2][3] The most common form of this invasive yeast infection is when Candida enters the bloodstream (candidemia). Signs of candidemia include fever and chills that do not improve with antibiotics. Symptoms of other types of systemic candidiasis depend on the organ or system which is infected. Systemic candidiasis is the most common fungal infection among hospitalized people in high-income countries, including the United States. Diagnosis can be difficult, especially when the Candida is not found in the bloodstream.[1][2] Treatment usually includes consists of oral or intravenous (IV) antifungal medications.[1][2][3]

Symptoms

Common symptoms of candidemia (Candida infection of the bloodstream) include fever and chills that do not improve with antibiotics. Candidemia can cause septic shock and therefore may include symptoms such as low blood pressure, fast heart rate, and rapid breathing.[1][2][3]

Systemic candidiasis may also affect other parts of the body such as the central nervous system (brain and spinal cord), abdomen, heart, kidneys, liver, bones, muscles, joints, spleen, and/or eyes.[1][2][3] Candidemia may be present, but not in all cases.[1] Signs and symptoms depend on the organ or system infected.[1][2][3] For example, when Candida infects the eye, symptoms may include blurred vision with photophobia (the eye is overly senstive to light), whereas symptoms of candida endocarditis (Candida infection of the inner lining of the heart) may include fever, shortness of breath, fluid buildup in the arms or legs, tiny red spots on the skin, and weight loss.[1][4] Since many people who develop systemic candidiasis are already sick, it can be difficult to know which symptoms are from Candida infection and which symptoms are from complications of other medical conditions.[2]

Cause

Systemic candidiasis is caused by Candida yeast. Although there are over 200 species (types), the five most common species of Candida to cause systemic infections include C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei. Candida normally live in the digestive tract (gastroinestinal system) and on skin and usually do not cause any problems. However if Candida enters the bloodstream, the yeast may overgrow. The overgrowth of Candida may also spread or occur in other parts of the body, including the liver, spleen, heart, eyes, lining of the abdomen and abdominal organs (peritoneum), kidney, bone, lungs and covering of the spinal cord and brain (meninges).[1][2][3]

People who may have an increased risk for systemic candidiasis include:[1][2][3]

  • People who have a weakened immune system (for example, people who have had an organ transplant, have HIV/AIDS, or are on cancer chemotherapy)
  • Intensive care unit (ICU) patients
  • People who have had surgery, especially gastrointestinal surgery
  • People who have a central venous catheter
  • Very low-birth-weight infants
  • People who have taken broad-spectrum antibiotics
  • People who have a very low neutrophil (a type of white blood cell) count (neutropenia)
  • People who have kidney failure or are on hemodialysis
  • People who have diabetes

Diagnosis

Systemic candidiasis is usually suspected in people who have an increased risk of developing an invasive Candida infection and have symptoms of an infection. Blood cultures (or cultures of other sterile fluids from the body such as cerebrospinal fluid) are then ordered to confirm the diagnosis.[1][2][3]

However, in 40-50% of cases when systemic candidiasis affects another part of the body, the blood culture may be negative.[1][2] In these cases, further testing will depend on which organ(s) or body system is infected.[1] As of 2016, medical researchers are hoping T2 magnetic resonance testing will be able to more accurately and easily detect all forms of systemic candidiasis.[5]

Treatment

Systemic candidiasis is usually treated with oral or intravenous (IV) antifungal medications, including echinocandin (caspofungin, micafungin, or anidulafungin) fluconazole, and amphotericin B. The specific type of medication and length of treatment will depend on many factors, including the age and health of the infected person, the location and severity of the infection, and the specific species of Candida causing the infection.[1][2][3][6] 

Antifungal medications may be given to certain high risk people in order to prevent the development of systemic candidiasis, however more studies are needed before it is clear if this practice is helpful.[2][6] 

For more information about the treatment of systemic candidiasis, please see the Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.

Learn more

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • You can obtain information on this topic from the Centers for Disease Control and Prevention (CDC). The CDC is recognized as the lead federal agency for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States.
  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • The Merck Manual provides information on this condition for patients and caregivers.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Merck Manual for health care professionals provides information on Systemic candidiasis.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Systemic candidiasis. Click on the link to view a sample search on this topic.

References

  1. Antinori S, Milazzo L, Sollima S, Galli M, and Corbellino M. Candidemia and invasive candidiasis in adults: A narrative review. Eur J Intern Med. October 2016; 34:21-28. https://www.ncbi.nlm.nih.gov/pubmed/27394927.
  2. Invasive Candidiasis. Centers for Disease Control and Prevention. June 12 2015; https://www.cdc.gov/fungal/diseases/candidiasis/invasive/.
  3. Hidalgo JA. Candidiasis. Medscape Reference. November 4 2016; https://emedicine.medscape.com/article/213853-overview.
  4. Vyas JA. Endocarditis. Medline Plus. December 7 2014; https://medlineplus.gov/ency/article/001098.htm.
  5. Pfaller MA, Wolk DM,and Lowery TJ. T2MR and T2Candida: novel technology for the rapid diagnosis of candidemia and invasive candidiasis. Future Microbiol. January 2016; 11(1):103-17. https://www.ncbi.nlm.nih.gov/pubmed/26371384.
  6. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, and Sobel JD. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. February 2016; 62(4):e1-50. https://cid.oxfordjournals.org/content/62/4/e1.

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