Case history
Case history #1
A 52-year-old woman with a history of Crohn's disease developed fevers while receiving total parenteral nutrition for 2 weeks. She underwent a small bowel resection followed by prolonged intravenous antibiotics for intra-abdominal abscess and fistulae. Examination reveals a temperature of 38.5°C (101°F), normal heart sounds without murmur, central venous catheter site without erythema or drainage, and no rash.
Case history #2
A 78-year-old man, who has insulin-dependent diabetes, presents with a neurogenic bladder, and is admitted with hypotension (BP 80/40), pulse 120 bpm, temperature of 39°C (102°F), and confusion. Urine examination reveals pyuria, and numerous budding yeast are visualised on urine microscopy.
Other presentations
The clinical presentation can vary from mild fever with leukocytosis to septic shock when clinical presentation is indistinguishable from bacterial sepsis. Although fever is the most common sign of systemic candidiasis, it can be absent. There are no specific clinical features, and diagnosis can be difficult if blood cultures are negative. Atypical features include skin lesions (nodules or pustules) or visual changes in patients with endophthalmitis.
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