What is Fungemia & How is it Treated?

Fungemia is a pathological condition in which there is presence of fungi in the blood stream. The species mostly seen to infiltrate the blood stream are the Candida species but other types of fungi may also infiltrate the blood and cause Fungemia. It should be noted here that a normal healthy person with a strong immune state cannot have Fungemia. It is seen only in people who are old and have a compromised immune state or suffer from medical conditions like HIV/AIDS, cancer or neutropenia which is a condition in which there is a depletion of the neutrophil count in the blood.

The fungi can invade the bloodstream through intravenous catheters or fungi growing within the intestines. People who are on broad spectrum antibiotics are also at risk for developing Fungemia as the antibiotics kill most of the bacteria within the stomach where some amount of fungi is always present. When these bacteria are killed it gives the fungi the space to grow and thus invade the bloodstream causing Fungemia.

As stated, fungi can invade the blood stream through intravenous catheters which are put in patients with compromised immune state or have medical disorders like neutropenia, cancer, or AIDS. Another way through which fungi can invade the bloodstream is through the intestines. This is mostly seen in people who are on broad spectrum antibiotics which kill all the bacteria present within the intestines where some amount of fungi is always present.

This gives the fungi a space to grow resulting in them invading the bloodstream causing Fungemia. The main fungi involved in development of Fungemia are Candida albicans, Candida glabrata and Aspergillus. It should be noted here again that an individual with a normal immune system and not on any antibiotics will not have Fungemia.

Some of the symptoms of Fungemia are extensive skin burns, fever, confusion and altered mental awareness, itchiness of the skin, nonhealing wounds, or unusual discharge from wounds. These symptoms tend to appear months after the fungi have invaded the bloodstream causing Fungemia.

Blood culture can be done to diagnose Fungemia but more often than not it may give a false positive result and hence the cultures need to be repeated in case the symptoms resemble that of Fungemia and other conditions causing the symptoms have been ruled out. The blood tests will also show repeated decreased levels of neutrophil which is a condition called neutropenia which again confirm the diagnosis of Fungemia.

The front line treatment for Fungemia is utilizing antifungals. These antifungals are given intravenously. The medications most preferred to treat Fungemia are Caspofungin or Micafungin. In some cases, fluconazole either orally or intravenously is also effective in treatment of Fungemia. In case if there is limited availability of antifungals then amphotericin B is quite an effective alternative in treating Fungemia, especially in people who have antifungal resistance or antifungal intolerance and develop Fungemia.

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