Bronchial tree colonization with Candida species is common in critically ill patients receiving mechanical ventilation, but primary Candida pneumonia and invasive disease are rare. Candida pneumonia is usually not due to aspiration of oropharyngeal secretions but rather to hematogenous spread from disseminated candidiasis (eg, osteomyelitis, septic arthritis, or endocarditis). As a result, diagnosis of Candida pneumonia requires histopathological confirmation.
Current guidelines do not recommend antifungal treatment or repeat cultures for immunocompetent patients with Candida from respiratory sputum or bronchoalveolar lavage unless they are immunocompromised. Antifungal treatment is also reserved for immunocompetent patients with a primary Candida infection at another site who develop new pulmonary lesions suspicious for hematogenous spread. Fluconazole is preferred for treating candidemia, but echinocandins (eg, micafungin) are recommended in patients with severe illness or recent azole exposure.
No backlinks found.