title: [Case report: Analysis of the critical time delays from the fever increase to the first antimycotic dose during the diagnosis of candidemia].
abstract: In a secondary care hospital in Germany with an in-house microbiology laboratory, an 84-year-old female patient with candidemia was selected for determination of the time periods required for each diagnostic step preceding the application of the first dose of antimycotic treatment. The total time from the beginning of fever to the first dose of fluconazole was 25 hours and 10 minutes. The largest delay occurred between the positive signal of the blood culture bottle during the night and the start of the work-up of the positive blood culture bottle in the morning. Improvements appear to be possible in both clinical and laboratory settings by optimizing pre-analytical, analytical, and post-analytical procedures.
authors.affiliation: Institut für Medizinische Laboratoriumsdiagnostik und Mikrobiologie, Südharz-Krankenhaus Nordhausen gGmbH, Dr.-Robert-Koch-Strasse 39, 99734 Nordhausen. Reinhard.Kappe@shk-ndh.de
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kappe
authors.forename: Erika
authors.initials: E
authors.lastname: Fuchs
authors.forename: Alexander
authors.initials: A
authors.lastname: Gorges
authors.forename: Dagmar
authors.initials: D
authors.lastname: Rimek
mesh_terms: D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002176:Candida albicans / Q000302:isolation & purification*; D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage* / Q000627:therapeutic use; D016469:Fungemia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005858:Germany; D006801:Humans; D008828:Microbiological Techniques; D013997:Time Factors
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole