[Analysis of 84 cases with fungemia].
Eighty-four patients with fungemia were analyzed. Fungi had been isolated by culture of blood samples, including blood from the catheter for intravenous hyperalimentation, between 1986-1990. Candida albicans (39.3%), Candida parapsilosis (20.2%), Candida tropicalis (11.9%), Candida glabrata (10.7%), Candida guilliermondii (4.8%) and Trichosporon beigelii (4.8%) were the most frequently isolated fungal pathogens. Four patients' blood yielded two different fungal species. Fifty-nine cases were male, and 25 cases were female. Forty-six of the 84 patients died (54.8%), but there were no differences in the overall mortality rate as a function of the fungal species or sex. All patients had underlying diseases: solid cancer, 37 cases; cardiovascular diseases, 9 cases; gastrointestinal diseases excluding gastrointestinal cancer, 8 cases; central nervous system diseases, 7 cases; premature infants and congenital abnormality, 7 cases; leukemia, 6 cases and miscellaneous, 10 cases. Twenty-four of the 46 dead cases were autopsied, and eight cases showed systemic fungal lesions. However, in one case of pulmonary cryptococcosis and one case of pulmonary penicilliosis, there was no correlation between the isolation of C. glabrata by blood culture and the pathological findings. A fungus-positive blood culture was surmised to be a result of contamination of the sample in 33 cases, and the mortality rate for those cases was 72.2% (24 cases). For 6 of the corpses, fungal lesions observed at autopsy were compatible with the types of lesions found by the fungi which had been isolated before death. Removal of the catheter reduced the mortality rate to 41.7%. Fungal endophthalmitis was diagnosed in six cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Nakazawa
S
S
Department of Internal Medicine, Juntendo University School of Medicine.
Mori
T
T
Hibiya
I
I
Oguri
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000382:microbiology; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D016469:Fungemia / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D014250:Trichosporon / Q000302:isolation & purification