Invasive candidiasis is most likely in patients with central venous catheters, parenteral nutrition, recent abdominal surgery, renal replacement therapy, prolonged broad-spectrum antibiotics or immunosuppression.
Where these risks are present in septic shock, early empirical antifungal therapy, with de-escalation later, is standard practice.
- Risk factors include central lines, total parenteral nutrition and recent abdominal surgery.
- Broad-spectrum antibiotics, dialysis and neutropenia raise risk further.
- Candida colonisation at multiple sites adds to suspicion.
- Reassess and stop empirical antifungals when cultures and clinical course allow.
Why it matters
Blood cultures for Candida are slow and often negative, so recognising risk is what shortens delay.
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