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Candida sepsisB37.7
Synonym(s)
Candidosis disseminated; Disseminated Candidosis
DefinitionThis section has been translated automatically.
Septic seeding of Candida albicans or other Candida species (especially in immunosuppression), mostly after candidoses of internal organs (lung, heart, intestine, CNS).
EtiopathogenesisThis section has been translated automatically.
Haematogenic spread of the pathogens.
LocalizationThis section has been translated automatically.
Generalized to trunk, face, extremities.
Clinical featuresThis section has been translated automatically.
Exanthema with 2-5 mm large reddish papules and pustules, possibly with purpura, fever, reduced general condition, vomiting, diarrhoea, weight loss.
DiagnosisThis section has been translated automatically.
Blood culture.
TherapyThis section has been translated automatically.
- Amphotericin B (e.g. Amphotericin B Bristol-Myers-Squibb) i.v. in combination with Flucytosin (e.g. Ancotil) i.v. Amphotericin B: day 1: 0.1 mg/kg bw, day 2: 0.2 mg/kg bw, day 3: 0.3 mg/kg bw then 0.3 (-1.0) mg/kg bw/day i.v., Flucytosin 150 mg/kg bw in 4 ED.
- Alternatively: Liposomal amphotericin B (e.g. AmBisome) initial 1 mg/kg bw i.v.; if required, stepwise increase to 3 mg/kg bw i.v. or Fluconazole (e.g. Diflucan) i.v. 2 times/day 200 mg.
- In case of failure of all above mentioned therapies:
- Attempt with caspofungin (e.g. Cancidas): initial 70 mg/day i.v. up to and including 7 days after the symptoms have subsided.
- Alternatively voriconazole: 2 times/day (every 12 hours) 6 mg/kg bw. Maintenance dose from day 2: 2 times/day 4 mg/kg bw i.v. up to and including 7 days after remission.
- Alternatively posaconazole: 2 times/day 400 mg (10 ml) p.o. (daily dose 800 mg) or 4 times/day 200 mg (5 ml) p.o. The duration of therapy depends on the severity of the underlying disease, recovery from immunosuppression and clinical response.
- Alternatively, anidulafungin: Initial 200 mg i.v. as single dose. Subsequently, 100 mg i.v. once/day according to the clinical response.
Progression/forecastThis section has been translated automatically.
Awkward.