Candidemia: What it looks like and why it matters

Candidemia is a bloodstream infection caused by Candida fungi. It can feel like a sudden, serious illness — high fever, chills, low blood pressure, and signs of sepsis. This infection is common in hospitals and can be life-threatening: mortality is often 20–40% depending on how fast care starts and whether the source is controlled.

Why does this happen? Candida normally lives on skin and in the gut. When the body's defenses are weakened or a device like a central venous catheter is in place, the fungus can slip into the bloodstream and spread. People in ICUs, those on long courses of broad‑spectrum antibiotics, total parenteral nutrition (TPN), or with weakened immune systems are at higher risk.

How doctors find and treat candidemia

Doctors start with blood cultures — the main test. Newer blood tests like beta‑D‑glucan or PCR can help detect fungal components faster, but cultures confirm species and let labs check drug sensitivity. If candidemia is suspected and the patient is unstable, clinicians often start empiric antifungal therapy right away.

First‑line treatment for most hospitalized patients is an echinocandin (caspofungin, micafungin, or anidulafungin). If the patient is stable and the lab shows a fluconazole‑susceptible species, doctors may switch to oral fluconazole. A key step is source control — remove or replace infected intravascular lines and check for deep infections such as endocarditis or eye involvement. Treatment usually continues for at least two weeks after the last positive blood culture and after clinical improvement, longer if there’s a deep focus.

Species differences and drug resistance

Candida albicans is common, but non‑albicans species like C. glabrata, C. parapsilosis, and the emerging C. auris behave differently and may resist some drugs. C. auris is a global concern because it can resist multiple antifungals and spreads in healthcare settings. That’s why labs identifying the exact species matters — it lets clinicians pick the right drug fast.

What can you do if you or a loved one is at risk? Ask the care team about catheter care and antibiotic necessity. If you notice sudden fever, shaking chills, worsening shortness of breath, or a new drop in blood pressure while hospitalized, speak up immediately. Early cultures and prompt antifungal therapy save lives.

Prevention in hospitals focuses on good hand hygiene, careful catheter handling, avoiding unnecessary broad antibiotics, and surveillance for outbreaks (especially for C. auris). If you’re discharged with a central line or on TPN, make sure you know how to care for it and when to seek help.