Advertisement
Surgery
Advanced searchSave search
Original communication| Volume 72, ISSUE 5, P730-736, November 1972

Disseminated candidiasis in the surgical patient

  • J.David Gaines
    Footnotes
    Affiliations
    From the Division of Allergy, Immunology, and Infectious Diseases, Palo Alto Medical Research Foundation, Palo Alto, Calif., USA

    From the Department of Medicine, Division of Infectious Diseases, Stanford University School of Medicine, Palo Alto, Calif., USA
    Search for articles by this author
  • Jack S. Remington
    Affiliations
    From the Division of Allergy, Immunology, and Infectious Diseases, Palo Alto Medical Research Foundation, Palo Alto, Calif., USA

    From the Department of Medicine, Division of Infectious Diseases, Stanford University School of Medicine, Palo Alto, Calif., USA
    Search for articles by this author
  • Author Footnotes
    ∗ Recipient of a Postdoctoral Fellowship (Grant AM01006-05) from the National Institutes of Health, Bethesda, Md.
DOI:https://doi.org/10.5555/uri:pii:0039606072902553
Disseminated candidiasis in the surgical patient
Previous ArticleStudies in prolonged liver preservation
Next ArticleImmune responses induced by human malignant melanoma in the rabbit
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Of the 82 cases of systemic candidiasis diagnosed at the Stanford University Medical Center and Palo Alto Veterans Administration Hospital from 1960 through 1970, 40 (49 percent) occurred in patients who had experienced a major surgical procedure. Abdominal surgery was the most common procedure, and 25 patients underwent two or more operations. Each of the patients had received multiple antibiotic therapy, and 50 percent were also receiving either corticosteroids, cytotoxic agents, radiotherapy, or combinations of these. In this series, 85 percent of the surgical patients died and in approximately half of them, Candida infection was considered to be the cause of death or a major contributing factor. The diagnosis of candidiasis was suspected before death in only 18 patients, and 28 of the 34 patients (82 percent) who died either did not receive antifungal therapy or were moribund at the time it was initiated. A discussion of appropriate culture techniques and of the newer serologic procedures helpful in the diagnosis of systemic candidiasis is presented, as well as appropriate guidelines for the prevention and treatment of such infections in the surgical patient.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Baker R.D.
        Leukopenia and therapy in leukemia as factors predisposing to fatal mycoses.
        Am. J. Clin. Pathol. 1962; 37: 358
        • Bodey G.P.
        Fungal infections complicating acute leukemia.
        J. Chronic Dis. 1966; 79: 667
        • Bodey G.P.
        • Nies B.A.
        • Mohberg N.R.
        • Freireich E.J.
        The effect of adrenal corticosteroid therapy on infection in acute leukemia.
        Am. J. Med. Sci. 1965; 250: 162
        • Bogen J.D.
        Local complications in 67 patients with indwelling venous catheters.
        Surg. Gynecol. Obstet. 1960; 110: 112
        • Boggs D.R.
        • Athens J.S.
        • Cartwright G.E.
        • Wintrobe M.M.
        The effects of adrenal glucocorticoids upon the cellular composition of the inflammatory exudates.
        Am. J. Path. 1964; 44: 763
        • Braude A.I.
        • Rock J.A.
        The syndrome of acute disseminated moniliasis in adults.
        Arch. Intern. Med. 1959; 104: 107
        • Crosby D.L.
        Fatal candidiasis following colonic sterilization with neomycin and bacitracin.
        Br. J. Urol. 1967; 39: 479
        • Curry C.R.
        • Quie P.G.
        Fungal septicemia in patients receiving parenteral hyperalimentation.
        N. Engl. J. Med. 1971; 285: 1221
        • Davies R.R.
        • Reeves D.S.
        5-fluorocytosine and urinary candidiasis.
        Br. Med. J. 1971; 1: 577
        • Drutz D.J.
        • Spickard A.
        • Koenig M.G.
        New approach to therapy with amphotericin B.
        in: Hobby G.L. Antimicrobial agents and chemotherapy, 1967, Proceedings of the Sixth Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Philadephia1967: 202-207
        • Duhig J.J.
        • Mead M.
        Systemic mycosis due to Monilia albicans.
        Med. J. Aust. 1951; 1: 179
        • Ellis C.A.
        • Spivack M.L.
        The significance of candidemia.
        Ann. Intern. Med. 1967; 67: 511
        • Fass R.J.
        • Perkins R.
        5-fluorocytosine in the treatment of cryptococcal and Candida mycoses.
        Ann. Intern. Med. 1971; 74: 535
        • Gordee R.S.
        • Simpson P.J.
        Relationships of x-irradiations to the enhancement of Candida albicans infections.
        J. Bacteriol. 1967; 94: 6

      15. Gaines, J. D., and Remington, J. S.: Diagnosis of deep infection with Candida—A prospective study of Candida precipitins. Submitted for publication.

        • Hart P.D.
        • Russell Jr., E.
        • Remington J.S.
        The compromised host and infection. II. Deep fungal infection.
        J. Infect. Dis. 1969; 120: 169
        • Hughes J.M.
        • Remington J.S.
        Systemic candidiasis: A diagnostic challenge.
        Calif. Med. 1972; 116: 8
        • Kozinn P.J.
        • Taschdjian C.L.
        Candida albicans: Saprophyte or pathogen? A diagnostic guideline.
        J. A. M. A. 1966; 198: 170
        • Louria D.B.
        • Stiff D.P.
        • Bennett B.
        Disseminated moniliasis in the adult.
        Medicine. 1962; 41: 307
        • Medoff G.
        • Dismukes W.E.
        • Meade III, R.H.
        • Moses J.
        Therapeutic program for Candida infection.
        in: Hobby G.L. Antimicrobial agents and chemotherapy, Proceedings of the Tenth Interscience Conference on Antimicrobial agents and Chemotherapy. American Society for Microbiology, Philadelphia, Pa1970: 286-290
        • Masterson J.G.
        • Nelson J.H.
        • Valenti C.
        Acute monilial infection as a cause of death.
        Am. J. Obstet. Gynecol. 1962; 84: 1799
        • Miller D.G.
        Patterns of immunological deficiency in lymphomas and leukemias.
        Ann. Intern. Med. 1962; 57: 703
        • Murray I.G.
        • Buckley H.R.
        • Turner G.C.
        Serological evidence of Candida infection after open-heart surgery.
        J. Med. Microbiol. 1969; 2: 463
        • Portnoy J.
        • Wolf P.L.
        • Webb M.
        • Remington J.S.
        Candida blastospores and pseudohyphae in blood smears.
        N. Engl. J. Med. 1971; 285: 1010
        • Preisler H.D.
        • Hasenclever H.
        • Henderson E.S.
        Anti-candida antibodies in patients with acute leukemia.
        Am. J. Med. 1971; 51: 352
        • Preisler H.D.
        • Hasenclever H.F.
        • Levitan A.A.
        • Henderson E.S.
        Serologic diagnosis of disseminated candidiasis in patients with acute leukemia.
        Ann. Intern. Med. 1969; 70: 19
        • Record C.O.
        • Skinner J.M.
        • Sleight P.
        • Speller D.C.E.
        Candida endocarditis treated with 5-fluorocytosine.
        Br. Med. J. 1971; 1: 262
        • Rifkind D.
        • Marchioro T.L.
        • Schneck S.A.
        • Hill R.B.
        Systemic fungal infections complicating renal transplantation and immunosuppressive therapy. Clinical, microbiologie, neurologic, and pathologic features.
        Am. J. Med. 1967; 43: 28
        • Rosner F.
        • Gabriel F.D.
        • Taschdjian C.L.
        • Cuesta M.B.
        • Kozinn P.J.
        Serologic diagnosis of systemic candidiasis in patients with acute leukemia.
        Am. J. Med. 1971; 51: 54
        • Seelig M.S.
        The role of antibiotics in the pathogenesis of Candida infections.
        Am. J. Med. 1966; 40: 887
        • Seelig M.S.
        Mechanisms by which antibiotics increase the incidence and severity of candidiasis and alter the immunological defenses.
        Bacteriol. Rev. 1966; 30: 442
        • Shadomy S.
        In vitro studies with 5-fluorocytosine.
        Appl. Microbiol. 1969; 17: 871
        • Shadomy S.
        Further in vitro studies with 5-fluorocytosine.
        Infect. Immunity. 1970; 2: 484
        • Smits B.J.
        • Prior A.P.
        • Arblaster P.G.
        Incidence of Candida in hospital inpatients and the effects of antibiotic therapy.
        Br. Med. J. 1966; 1: 208
        • Taschdjian C.L.
        • Kozinn P.J.
        • Fink H.
        • Cuesta M.B.
        • Caroline L.
        • Kantrowitz A.B.
        Postmortem studies of systemic candidiasis. I. Diagnostic validity of precipitin reaction and probable origin of sensitization to cytoplasmic candidal antigens.
        Sabouraudia. 1969; 7: 110
        • Taschdjian C.L.
        • Kozinn P.J.
        • Toni E.F.
        Opportunistic yeast infections, with special reference to candidiasis.
        Ann. N. Y. Acad. Sci. 1970; 174: 606
        • Toala P.
        • Schroeder S.A.
        • Daly K.A.
        • Finland M.
        Candida at Boston City Hospital.
        Arch. Intern. Med. 1970; 126: 983
        • Torack R.M.
        Fungus infections associated with antibiotic and steroid therapy.
        Am. J. Med. 1957; 22: 872
        • Vic-Dupont V.
        • Cartier F.
        • Margairaz A.
        • Monsallier J.F.
        • Pocidalo J.J.
        • Couland J.P.
        Les septicemies. Complications des catheterismes veineux de perfusion.
        Bull. Soc. Mem. Hosp. Paris. 1966; 117: 89
        • Winn W.A.
        The use of amphotericin B in the treatment of coccidioidal disease.
        Am. J. Med. 1959; 27: 617

      Article info

      Publication history

      Accepted: April 17, 1972

      Footnotes

      ☆Supported by a grant from the John A. Hartford Foundation, Inc.

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606072902553

      Copyright

      © 1972 Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX