Assessing candiduria in a critically ill patient

doi:10.1136/bmj.b2289

Published 19 June 2009, doi:10.1136/bmj.b2289
Cite this as: BMJ 2009;338:b2289

Practice

Rational Testing

Assessing candiduria in a critically ill patient

William W Hope, clinical senior lecturer and honorary consultant in infectious diseases

¹ School of Translational Medicine, University of Manchester, Manchester M13 9PT

william.hope@manchester.ac.uk

Candiduria is common and often benign, but it may be the onlyclue to disseminated candidiasis in critically ill patients

The first 150 words of the full text of this article appear below.

A 56 year old man was admitted to the intensive care unit froma general surgical ward with pancreatitis, diagnosed on thebasis of clinical findings and a high amylase concentrationthought to be secondary to alcohol abuse. He had no relevantmedical history. In the general surgical ward he had been initiallytreated with ampicillin, gentamicin, and metronidazole to coverthe likely bacterial pathogens. His early clinical course inintensive care was complicated by persistent fevers to 39.5°C,haemodynamic instability, acute renal failure, and adult respiratorydistress syndrome. Mechanical ventilation was needed. A subclaviancentral line, arterial line, and indwelling catheter were requiredfor supportive care. Computed tomography soon after admissionto intensive care did not show any collection within the pancreas.On his admission to intensive care, antimicrobial treatmentwas broadened to meropenem because of persistent inflammation.Because of several risk factors for disseminated candidiasis(pancreatitis, broad spectrum . . . [Full text of this article]