Candida Sepsis

Disseminated candidiasis secondary to fungal and bacterial peritonitis in a young dog

“…Candida peritonitis is defined as the isolation of organisms from a peritoneal sample (obtained by laparotomy or percutaneous puncture) and has been associated with perforation of an abdominal organ, dehiscence of an intestinal suture with peritonitis, severe acute pancreatitis, or the presence of a peritoneal catheter for dialysis 12 in human patients. The development of systemic candidiasis in humans has several proposed patient risk factors including extended hospitalization in an intensive care unit, central venous catheters, urinary catheters, hyperglycemia, critical illness, hemodialysis, total parenteral nutrition, abdominal surgery, damaged mucosal barrier (from trauma or burns), immunosuppressive medications, age, azotemia, mechanical ventilation, multiple blood transfusion, and pancreatitis 2,3,9,13–16 . Neutropenia is also a known risk factor and it has been shown that granulocyte transfusions reduce the severity of disease in an experimental canine model of C. albicans infection 17 .…”

“…virulence factors that impact the ability of Candida spp. to invade host tissue including proteases, phospholipases, endothelial, and subendothelial adhesins 14,15 …”

“…Sepsis caused by Candida spp. clinically resembles bacterial sepsis, but the mechanism is not as well characterized 14,19 . Clinical signs of systemic candidiasis in humans and in dogs include persistent pyrexia and leukocytosis 3,4,9,20 .…”

Fungal Sepsis in Surgical Patients

“…The following data were recorded relative to the date of the first positive blood cultures: (1) positive bacterial blood cultures be¬ tween days -2 and +2, (2) urine cultures positive for fungemia between days -1 and +1, (3) nystatin prophylaxis from at least day -2, (4) hyperalimentation on day 0, (5) steroid therapy from at least day -2, (6) and antibiotic therapy for at least seven days, terminating no earlier than day -5. Other clinical data of particu¬ lar interest included temperature and WBC count on day 0, positive bacterial blood cultures, treatment with multiple antibiot¬ ics, fungal cultures from other sites, amphotericin therapy, and deaths.…”

“…(4) Who is likely to die? (5) Will prophylaxis prevent fungemia? (6) What treatment should be given?…”