Overview
Clinical Meaning
Fungal sepsis, most commonly caused by Candida species (candidemia), occurs when fungi enter the bloodstream, typically in immunocompromised, critically ill patients with risk f...
Fungal sepsis, most commonly caused by Candida species (candidemia), occurs when fungi enter the bloodstream, typically in immunocompromised, critically ill patients with risk factors including broad-spectrum antibiotic use, central venous catheters, total parenteral nutrition, abdominal surgery, and neutropenia. Candida albicans forms biofilm on indwelling catheters, providing a protected reservoir for continuous seeding into the bloodstream. The innate immune response to fungal cell wall components (beta-glucan, mannan) involves pattern recognition by dectin-1 and mannose receptors on macrophages and neutrophils, but the inflammatory response is often less robust than in bacterial sepsis, leading to delayed diagnosis. Serum beta-D-glucan and blood cultures (which have only 50% sensitivity for candidemia) guide diagnosis. The nurse monitors for signs of disseminated candidiasis (new skin lesions, endophthalmitis, hepatosplenic candidiasis), administers prescribed antifungal therapy (echinocandins as first-line, fluconazole for susceptible species), ensures removal of central venous catheters (source control), monitors hepatic and renal function during antifungal therapy, and obtains repeat blood cultures to document clearance.
