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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.
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Accepted: April 17, 1972
☆Supported by a grant from the John A. Hartford Foundation, Inc.
© 1972 Published by Elsevier Inc.