Fungemia by Candida non albicans in patients with HIV infection
Palacios, R.; Santos, J.; Romero, C.; García, V.; Rivero, A.; Márquez, M.
Enfermedades Infecciosas y Microbiologia Clinica 17(6): 279-282
1999
ISSN/ISBN: 0213-005X PMID: 10439537 Document Number: 510963
To analyse candidemia by Candida non albicans in adult HIV-infected patients from 1989 to August 1998. We retrospectively reviewed all HIV patients who presented at least one positive peripheral blood culture for Candida spp. Clinical, epidemiologic, immunologic and evolutive characteristics, and risk factors for candidemia were analysed. During this period of time, 2,025 HIV-infected patients were diagnosed. Five of them developed candidemia by C. albicans and 6 by C. non albicans. These last ones were all men with mean age of 32.1 years old, and intravenous drug use was the risk factor for HIV in 5 of them; aids had previously been diagnosed in 4 patients and 3 had receipt imidazoles. None was neutropenic. Three cases were nosocomially acquired. Median CD4 cell count was 108.6 x 10(6)/l (3-366). Candida krusei was isolated in two intravenous drug users, Candida parapsilosis in two other patients and Candida glabrata and Candida tropicalis in one of the other two cases each. We treated 2 patients with amphotericin B and 2 with fluconazole. One patient died. Candidemia is not frequent in HIV-infected patients. Candidemia by C. non albicans in HIV-infected patients presents similar characteristics as in other immunodepressed patients and it is fundamentally associated with previous use of imidazoles, nosocomial acquisition and late-stage aids. It is noteworthy that C. krusei was isolated in two intravenous drug users.