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PedsCrit

Invasive Candidiasis with Dr. Paul Sue and Dr. Sara Dong

Aug 19, 2024
Dr. Paul Sue, an expert in pediatric infectious diseases, and Dr. Sara Dong, a physician specializing in transplant and immunocompromised host infections, delve into the complexities of invasive candidiasis in pediatric care. They emphasize the critical difference between candidiasis and colonization, shedding light on severe mortality risks for immunocompromised patients. The conversation tackles management strategies, including the necessity of indwelling line removal and the potential of granulocyte therapy, while navigating the challenges of treating critically ill children.
26:37

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Quick takeaways

  • Understanding the distinction between invasive candidiasis and simple colonization is crucial for accurate diagnosis and treatment, especially in immunocompromised patients.
  • Effective management of invasive candidiasis involves balancing treatment options with source control and considering the patient's unique immunosuppression factors.

Deep dives

Understanding Invasive Candidiasis

Invasive candidiasis is defined primarily as candidemia or evidence of invasive organ disease, as established by the European Organization for Research and Treatment of Cancer (EORTC) through their Mycosis Study Group. The differentiation between invasive candidiasis and simple colonization is crucial, particularly as colonization is often misidentified when isolated from non-sterile sites, such as urine or endotracheal tubes. The absence of candidemia with positive blood cultures does not exclude invasive candidiasis; isolation from sterile sites, like an abscess, is necessary for a definitive diagnosis. Recognizing these distinctions is vital due to the significant mortality rates attributed to invasive candidiasis, especially in immunocompromised patients, where estimates can range from 15% up to 40%.

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