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relating to a technique in which the body is entered by puncture or incision
marked by a tendency to spread especially into healthy tissue; "invasive cancer cells"
an infection caused by fungi of the genus Monilia or Candida (especially Candida albicans) (同)moniliasis, monilia disease

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/05/02 08:29:51」(JST)

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Fungemia (Fungaemia in the UK and other Commonwealth countries) is the presence of fungi or yeasts in the blood. The most common type, also known as Candidemia, Candedemia, or Invasive Candidiasis, is caused by Candida species, but infections by other fungi, including Saccharomyces, Aspergillus and Cryptococcus, are also called fungemia. It is most commonly seen in immunosuppressed or immunocompromised patients with severe neutropenia, oncology patients, or in patients with intravenous catheters. It has been suggested the otherwise immunocompetent patients taking infliximab may be at a higher risk for fungemia.

Diagnosis is difficult, as routine blood cultures have poor sensitivity.

Treatment

Treatment involves use of antifungals such as fluconazole and amphotericin.

Risk factors

The three most important risk factors are:

Use of broad-spectrum antibiotics
Presence of mercury and other heavy metals.^{[citation needed]}
Colonization by fungi (see e.g. candidiasis)

Other risk factors are:

Dialysis
Diabetes
Lowered intestinal flora
Suppressed Immune system
Use of yeast probiotics [1]
Central venous catheter
High severity of illness
Multiple abdominal surgeries
Use of steroids
burns

Pathogens

The most commonly known pathogen is Candida albicans, causing roughly 70% of fungemias, followed by Candida glabrata with 10%, Aspergillus with 1% and Saccharomyces as the fourth most common.^{[citation needed]} However, the frequency of infection by C. glabrata, Saccharomyces boulardii, Candida tropicalis, C. krusei and C. parapsilosis is increasing, perhaps because significant use of fluconazole is common or due to increase in antibiotic use.

Symptoms

Symptoms can range from mild to extreme—often described as extreme flu-like symptoms. Many symptoms may be associated with fungemia, including pain, mental disorders, chronic fatigue, and infections. Skin infections can include persistent or non-healing wounds and lesions, sweating, itching, and unusual discharge or drainage.

External links

Treatment of fungal infections
Candidiasis: Overview and Full Index
Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009;48:503-53.

UpToDate Contents

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1. 成人におけるカンジダ菌血症および侵襲性カンジダ症 treatment of candidemia and invasive candidiasis in adults
2. 成人におけるカンジダ菌血症および侵襲性カンジダ症の臨床症状および診断 clinical manifestations and diagnosis of candidemia and invasive candidiasis in adults
3. カンジダ感染症の概要 overview of candida infections
4. 成人におけるカンジダ菌血症の疫学および病因 epidemiology and pathogenesis of candidemia in adults
5. 小児におけるカンジダ感染症の概要 overview of candida infections in children

English Journal

Polymeric microparticles-based formulation for the eradication of cutaneous candidiasis: development and characterization.

Kumar L1, Verma S, Jamwal S, Vaidya S, Vaidya B.Author information 1Department of Pharmaceutics .AbstractCutaneous candidiasis is a common topical fungal infection which may be more prominent in patients associated with AIDS. It is usually treated by conventional formulations such as cream, gel, which show various adverse effects on skin along with systemic absorption. To overcome these drawbacks, various novel drug delivery systems have been explored. Poly(lactic-co-glycolic acid) (PLGA)-based microparticulate systems have shown good dermal penetration after topical application. Therefore, in the present study clotrimazole-loaded PLGA microspheres were prepared for targeted dermal delivery. Microspheres were prepared by using a single emulsification (oil-in-water, O/W) evaporation technique and characterized for different parameters. Prepared microparticulate systems were dispersed in Carbopol 934® gel and antifungal activity was carried out on experimentally induced cutaneous candidiasis in immunosuppressed guinea pigs. Particle size of optimized formulation was 2.9 µm along with 74.85% entrapment of drug. Skin retention studies revealed that drug accumulation in the skin was higher with microspheres gel as compared to marketed gel. Confocal microscopy of skin further confirmed penetration of microspheres up to 50 µm into the dermal region. In-vivo antifungal activity studies demonstrated that microsphere gel showed better therapeutic activity, lowest number of cfu/ml was recorded, as compared to marketed gel after 96 h of application. Based on the results of the study, it can be concluded that PLGA microparticles may be promising carriers to deliver clotrimazole intradermally for the treatment of invasive fungal infections.
Pharmaceutical development and technology.Pharm Dev Technol.2014 May;19(3):318-25. doi: 10.3109/10837450.2013.778874. Epub 2013 Apr 8.
Cutaneous candidiasis is a common topical fungal infection which may be more prominent in patients associated with AIDS. It is usually treated by conventional formulations such as cream, gel, which show various adverse effects on skin along with systemic absorption. To overcome these drawbacks, vari
PMID 23560821

The Prospective Antifungal Therapy Alliance(®) registry: A two-centre Canadian experience.

Haider S1, Rotstein C2, Horn D3, Laverdiere M4, Azie N5.Author information 1Hamilton Health Sciences, McMaster University, Hamilton;2University Health Network, University of Toronto, Toronto, Ontario;3David Horn, LLC, Doylestown, Pennsylvania, USA;4University of Montreal, Hôpital Maisonneuve-Rosemont, Montreal, Quebec;5Astellas Pharma Global Development, Northbrook, Illinois, USA.Abstractin

English, FrenchHISTORIQUE: Le registre PATH de la Prospective Antifungal Therapy Alliance est une étude de surveillance prospective qui a permis de colliger des données sur le diagnostic, la prise en charge et les issues des infections fongiques invasives (IFI) provenant de 25 centres d’Amérique du Nord entre 2004 et 2008.

The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie médicale / AMMI Canada.Can J Infect Dis Med Microbiol.2014 Spring;25(1):17-23.
in

English, FrenchHISTORIQUE: Le registre PATH de la Prospective Antifungal Therapy Alliance est une étude de surveillance prospective qui a permis de colliger des données sur le diagnostic, la prise en charge et les issues des infections fongiques invasives (IFI) provenant de 25 centres d’A

PMID 24634683

Japanese Journal

Synergistic antifungal effect of lactoferrin with azole antifungals against Candida albicans and a proposal for a new treatment method for invasive candidiasis

Kobayashi Tsutomu,Kakeya Hiroshi,Miyazaki Taiga [他]
Japanese Journal of Infectious Diseases 64(4), 292-296, 2011-07
NAID 40018924977

乾酪様物質を伴う副鼻腔炎の手術例の検討

松原弘,都築建三,竹林宏記,岡秀樹,深澤啓二郎,阪上雅史
耳鼻咽喉科臨床 103(7), 643-649, 2010-07-01
… Postoperatively, 16 with caseous sinusitis and 31 with non invasive myocetoma recovered uneventfully. … In 3 with acute invasive cases, two survived with ongoing visual impairment. … One with invasive candidiasis died of brain invasion. …
NAID 10029062524