Candidemia Workup and Management - IDSA Guidelines
1) Antibiotics
• Empiric: Echinocandins (e.g. micafungin) for most patients
• Transition to fluconazole pending: Susceptibilities, Negative Cultures
• Length: 2 Weeks minimum (if no complications)
2) Lines and Tubes
• Central Venous Catheters (CVL/PICC) - If candidemia felt to be due to central venous line, it should be removed ASAP
• Other hardware - Risk-Benefit Discussion
3) Complications
• Ocular - Eye exam within one week to assess ocular involvement
• Cardiac - No specific recommendations. Generally no routine TTE or TEE unless clinical concern for endocarditis
• Additional metastatic workup dictated by symptoms. Consider: Spine, CNS, liver, spleen, or GU tract
By Brian Russell MD @brian_russell39 and Dr. Sara Dong @swinndong via @iMedEducation
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