Candidemia: what it is and why it matters
Candidemia is a bloodstream infection caused by Candida yeast. It sounds rare, but in hospitals—especially in ICUs—it’s a common and serious cause of sepsis. A simple fever or unexplained decline in a sick patient can hide candidemia. Catching it early changes outcomes, so this page focuses on what to watch for, how doctors diagnose it, and practical treatment steps you can expect.
Who’s at risk and what causes it
Most cases start when Candida gets access to the bloodstream. Common triggers include central venous catheters, total parenteral nutrition (TPN), recent major surgery, broad-spectrum antibiotics, and weakened immunity (chemo, steroids, transplants). ICU patients, people with prolonged hospital stays, and those with diabetes or kidney failure are more likely to get candidemia. If you or a loved one has these risk factors and a new fever that doesn’t respond to antibiotics, ask about fungal testing.
How candidemia is diagnosed
Blood cultures are the main test. They can take a day or more and sometimes miss the infection. Newer lab tests like beta-D-glucan or molecular panels (T2Candida) help detect Candida faster, but availability differs by hospital. Doctors often use a combination: blood culture plus one of these rapid tests, especially when suspicion is high. A key part of work-up is looking for spread outside the blood—eyes (ophthalmology exam), heart (echocardiogram), and abdomen—to catch deep infections early.
Treatment and quick steps
Start treatment promptly if candidemia is likely. Most guidelines recommend an echinocandin (caspofungin, micafungin, anidulafungin) as first-line therapy for most patients. If the Candida species is identified and is susceptible, clinicians often switch to fluconazole as a step-down option. Removing or replacing an infected central line quickly is crucial—this simple move often helps clear the infection. Treatment usually continues for at least 14 days after the last positive blood culture and after symptoms improve.
Watch for complications: candidemia can seed the eyes (endophthalmitis), heart valves (endocarditis), and deeper organs. That’s why follow-up exams and targeted imaging matter. Also, antifungal drug choice may change if the species is resistant—Candida glabrata and Candida auris need special attention.
Prevention matters. Good catheter care, limiting unnecessary antibiotics, hand hygiene, and targeted antifungal prophylaxis in select high-risk groups cut risk. If you’re a patient or caregiver, ask about line care and why a particular antifungal was chosen.
If you have specific questions about symptoms, tests, or a prescribed antifungal, bring them up with your care team. Quick recognition and the right early steps make a big difference with candidemia.
