fungemia

Symptoms can range from mild to extreme—often described as extreme flu-like symptoms. Many symptoms may be associated with fungemia, including pain, acute confusion, chronic fatigue, and infections. Skin infections can include persistent or non-healing wounds and lesions, sweating, itching, and unusual discharge or drainage.{{citation needed|date=June 2016}}

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The most important risk factors are:{{citation needed|date=August 2021}}

• Use of broad-spectrum antibiotics
• Active infection by fungi (see e.g. candidiasis)}}

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Other risk factors are:

• Dialysis
• Diabetes
• Lowered intestinal flora
• Suppressed immune system
• Use of yeast probiotics{{cite journal |vauthors=Herbrecht R, Nivoix Y |title=Saccharomyces cerevisiae fungemia: an adverse effect of Saccharomyces boulardii probiotic administration |journal=Clinical Infectious Diseases |volume=40 |issue=11 |pages=1635–7 |year=2005 |pmid=15889361 |doi=10.1086/429926 |jstor=4484255 |doi-access=free }}
• Central venous catheter
• High severity of illness
• Multiple abdominal surgeries
• Use of steroids
• Burns

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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|date=August 2010}} 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.{{citation needed|date=June 2016}}

Candida auris is an emerging multidrug-resistant (MDR) yeast that can cause invasive infections and is associated with high mortality. It was first described in 2009 after being isolated from external ear discharge of a patient in Japan. Since the 2009 report, C. auris infections, specifically fungemia, have been reported from South Korea, India, South Africa, and Kuwait. Although published reports are not available, C. auris has also been identified in Colombia, Venezuela, Pakistan, and the United Kingdom.{{Cite web |url=https://www.cdc.gov/fungal/diseases/candidiasis/candida-auris-alert.html | title=Clinical Alert to U.S. Healthcare Facilities – June 2016 | Candida auris | Fungal Diseases | CDC| date=24 January 2019}}

In a single reported instance, Psilocybe cubensis was reported to have been cultured from a case of fungemia in which an individual self-injected an underprocessed decoction of fungal matter.{{cite journal |last1=Giancola |first1=Nicholas B. |last2=Korson |first2=Clayton J. |last3=Caplan |first3=Jason P. |last4=McKnight |first4=Curtis A. |title=A 'trip' to the ICU: intravenous injection of psilocybin |journal=Journal of the Academy of Consultation-Liaison Psychiatry |date=11 January 2021 |volume=62 |issue=3 |pages=370–371 |doi=10.1016/j.jaclp.2020.12.012 |pmid=34102133 |s2cid=234167275 |id={{PII|S266729602030015X}} |doi-access=free }}{{unreliable source?|date=January 2021}} The patient, who had been experiencing depression, attempted to self-medicate with the mushrooms but was frustrated by the lag time between eating the mushrooms and experiencing the psychedelic effects. In an attempt to bypass this, the patient boiled and filtered the mushrooms into a 'mushroom tea' which was then administered by injection. The patient had multiple organ failure, but this was successfully reversed and the infection treated with antifungal drugs.{{Cite web|title=Psychedelic Mushrooms Grew in a Man's Veins After He Injected Them|url=https://gizmodo.com/psychedelic-mushrooms-grew-in-a-mans-veins-after-he-inj-1846044856|access-date=26 January 2021|website=Gizmodo|date=12 January 2021 |language=en-us}} Two other examples of fungemia as a result of injecting fungal matter in this way have been described in medical literature, both dating to 1985.{{Cite web|title=Man Injects Psilocybin Mushrooms and They Grow in His Veins {{!}} Mysterious Universe|url=https://mysteriousuniverse.org/2021/01/man-injects-psilocybin-mushrooms-and-they-grow-in-his-veins/|access-date=26 January 2021|website=mysteriousuniverse.org|language=en-US}}

The gold standard for the diagnosis of invasive candidiasis and candidemia is a positive culture. Blood cultures should be obtained in all patients with suspected candidemia.{{Cite web |title=UpToDate |url=https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-candidemia-and-invasive-candidiasis-in-adults |access-date=20 May 2022 |website=www.uptodate.com}}

Neutropenic vs non-neutropenic candidemia is treated differently.

An intravenous echinocandin such as anidulafungin, caspofungin or micafungin is recommended as first-line therapy for fungemia, specifically candidemia. Oral or intravenous fluconazole is an acceptable alternative.{{cite journal |vauthors=Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, Sobel JD |title=Executive Summary: Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America |journal=Clinical Infectious Diseases |volume=62 |issue=4 |pages=409–17 |year=2016 |pmid=26810419 |doi=10.1093/cid/civ1194 |doi-access=free }} The lipid formulation amphotericin B is a reasonable alternative if there is limited antifungal availability, antifungal resistance, or antifungal intolerance.

• Bacteremia
• Candidiasis
• Fungicide
• Mycosis

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{{Infectious blood tests}}

{{Mycoses}}

Category:Animal fungal diseases

Category:Abnormal clinical and laboratory findings for blood

Category:Sepsis