Disseminated candidiasis, also known as invasive candidiasis, Candida septicemia, or systemic candidiasis, arises as a result of Candida species in the blood and is predominantly caused by Candida albicans species, although non-albicans Candida species are rising in prevalence, particularly in hospitalized patients. Candida species on a blood culture should not be considered a contaminant. Systemic candidiasis varies in its severity and clinical presentation. It can range from a mild presentation to more widespread and disseminated disease involving multiple organs, sepsis, and shock. Systemic candidiasis is more common among immunosuppressed patients and chronically or critically ill children, in addition to patients with a defective or compromised skin barrier. Other risk factors include having a central venous catheter, hematologic malignancy, or stem-cell transplant, receiving parenteral nutrition, receiving hemodialysis, and being on broad-spectrum antibiotics.

Organ systems commonly affected include the kidneys, with over half of patients manifesting some form of renal involvement, which may include candiduria, hypertension, renal failure, abscess formation, and the development of fungal balls leading to obstruction and hydronephrosis. Central nervous system (CNS) involvement is also frequent, occurring in one-third of cases, and may result in abscess formation. Endophthalmitis is seen in almost half of all cases.

Cutaneous manifestations of systemic Candida infection include a generalized dermatitis, which may be followed by desquamation. Other common skin findings range from discrete pustules and erythematous or pink papules to nodules and necrotic skin. Macules may also be present. Chorioretinitis is characteristic.

Generalized symptoms include spiking fevers, chills, headache, hypotension, respiratory distress, blurred vision, and prostration. Myalgias, arthralgias, and osteoarthritis may be present. Pneumonia occurs in 70% of patients.

Systemic candidiasis is a serious illness that is associated with significant morbidity and mortality.

Candida auris
Candida auris is an emerging cause of candidemia that is notable for high rates of mortality and for drug resistance. Candida auris mostly affects patients with severe underlying medical conditions requiring complex medical care. Patients with invasive medical devices such breathing tubes, feeding tubes, catheters in a vein, or urinary catheters tend to be at increased risk. Nosocomial infection has been associated with prolonged use of axillary temperature monitors.

Consultation with an infectious disease specialist is highly recommended when caring for patients with C auris infection. Even after treatment for invasive infections, patients generally remain colonized with C auris for long periods.

See below and the US Centers for Disease Control and Prevention (CDC) Information for Laboratorians and Health Professionals for more detailed information.