Clinical characteristics and outcomes of patients with chronic disseminated candidiasis who need adjuvant corticosteroid therapy

We performed a retrospective study involving 21 patients with chronic disseminate candidiasis (CDC) and 38 patients with candidemia. Neutropenia of >2 weeks' duration was more common in those with CDC (71%) than in those with candidemia (26%, P < .001), and the azole-resistant rate in pat...

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Bibliographic Details
Published in:Medical mycology (Oxford) 2018-08, Vol.56 (6), p.782-786
Main Authors: Jang, Young-Rock, Kim, Min-Chul, Kim, Taeeun, Chong, Yong Pil, Lee, Sang-Oh, Choi, Sang-Ho, Kim, Yang Soo, Woo, Jun Hee, Hong, Jung Yong, Yoon, Dok Hyun, Suh, Cheolwon, Lee, Jung-Hee, Lee, Je-Hwan, Lee, Kyoo-Hyung, Kim, Sung-Han
Format: Article
Language:English
Subjects:
Adjuvants, Immunologic - therapeutic use
Adrenal Cortex Hormones - therapeutic use
Adult
Antifungal Agents - therapeutic use
Candida - classification
Candidemia - diagnosis
Candidemia - drug therapy
Candidemia - microbiology
Candidemia - physiopathology
Candidiasis - diagnosis
Candidiasis - drug therapy
Candidiasis - microbiology
Candidiasis - physiopathology
Chronic Disease
Combined Modality Therapy
Drug Resistance, Fungal
Female
Fever - drug therapy
Humans
Immune Reconstitution Inflammatory Syndrome - drug therapy
Immune Reconstitution Inflammatory Syndrome - physiopathology
Male
Middle Aged
Neutropenia - complications
Opportunistic Infections - diagnosis
Opportunistic Infections - drug therapy
Opportunistic Infections - microbiology
Opportunistic Infections - physiopathology
Retrospective Studies
Treatment Outcome
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Summary:We performed a retrospective study involving 21 patients with chronic disseminate candidiasis (CDC) and 38 patients with candidemia. Neutropenia of >2 weeks' duration was more common in those with CDC (71%) than in those with candidemia (26%, P < .001), and the azole-resistant rate in patients with CDC (5%) was lower than that in those with candidemia (29%, P = .03). Of the 21 patients with CDC, five (24%) needed adjuvant corticosteroid therapy due to persistent debilitating fever (median, 19 days). Rapid defervescence (median, 5 days) occurred after adjuvant corticosteroid therapy. However, there were no significant differences in 90-day mortality between CDC patients with and without corticosteroid therapy. Further prospective data are needed to define the role of steroids in this setting.
ISSN:1369-3786
1460-2709
DOI:10.1093/mmy/myx110