fungemia

Fungemia
	Classification and external resources
ICD-9	117.9
MeSH	D016469

真菌血症

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/28 18:35:49」(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. 小児におけるカンジダ感染症：概要 candida infections in children an overview
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. 頭部白癬 tinea capitis

English Journal

Risk factors predictive of endogenous endophthalmitis among hospitalized patients with hematogenous infections in the united states.

Vaziri K1, Pershing S2, Albini TA1, Moshfeghi DM3, Moshfeghi AA4.
American journal of ophthalmology.Am J Ophthalmol.2015 Mar;159(3):498-504. doi: 10.1016/j.ajo.2014.11.032. Epub 2014 Dec 6.
PURPOSE: To identify potential risk factors associated with endogenous endophthalmitis among hospitalized patients with hematogenous infections.DESIGN: Retrospective cross-sectional study.METHODS: MarketScan Commercial Claims and Encounters, and Medicare Supplemental and Coordination of Benefit inpa
PMID 25486541

Candida fermentati as a Cause of Persistent Fungemia in a Preterm Neonate Successfully Treated by Combination Therapy with Amphotericin B and Caspofungin.

Al-Sweih N1, Ahmad S2, Joseph L2, Khan S3, Vayalil S4, Chandy R2, Khan Z5.
Journal of clinical microbiology.J Clin Microbiol.2015 Mar;53(3):1038-41. doi: 10.1128/JCM.03351-14. Epub 2015 Jan 7.
A case of persistent candidemia in a preterm neonate caused by Candida fermentati, identified by sequencing of the internally transcribed spacer region of ribosomal DNA (rDNA), is described. The neonate was treated for 30 days by combination therapy with amphotericin B (AmBisome) and caspofungin wit
PMID 25568433

Invasive fungal infections in children with hematologic and malignant diseases.

Ozsevik SN1, Sensoy G, Karli A, Albayrak C, Dagdemir A, Belet N, Elli M, Fisgin T, Ozyurek E, Duru F, Albayrak D.
Journal of pediatric hematology/oncology.J Pediatr Hematol Oncol.2015 Mar;37(2):e69-72. doi: 10.1097/MPH.0000000000000225.
BACKGROUND: To evaluate the clinical feature and outcome of invasive fungal infections (IFI) in children with hematologic and malign diseases.PATIENTS AND METHODS: The medical records of children with hematologic and malignant diseases, who were hospitalized at our hospital between January 2010 and
PMID 25072372

Japanese Journal

症例報告ステロイド長期投与患者に発症した皮膚クリプトコッカス症および真菌血症の1例

臨床皮膚科 = Japanese journal of clinical dermatology 71(7), 533-537, 2017-06
NAID 40021226623

症例報告 Kodamaea ohmeriによるカテーテル関連血流感染症の1例

日本外科感染症学会雑誌 12(1), 55-59, 2015-02
NAID 40020386702

臨床研究・症例報告 C.parapsilosisによる真菌血症を来したDuchenne型筋ジストロフィーの1例

小児科臨床 68(1), 137-140, 2015-01
NAID 40020305042

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