[Visceral candidiasis]. / Candidoses viscérales.

ABSTRACT

Invasive candidiasis is a frequent infection in compromised patient. Several risk factors have been identified and include neutropenia, broad-spectrum antibiotherapy, colonisation with a Candida spp. and presence of central venous catheter. Candidemia is the most common clinical aspect. Diagnosis is based on positive culture of blood, skin biopsy or fine needle aspiration of a deep-seated lesion. Serology is not helpful in severely immunocompromised patients. Prophylaxis is based on strict hygiene and, in neutropenic patients, oral fluconazole. Treatment of an invasive candidiasis depends on the localisation of the infection, of its acute or chronic evolution, on the species involved and on underlying condition. Amphotericin B deoxycholate or in lipid formulation and fluconazole are the antifungal drugs of choice. Removal of a central venous catheter should always be discussed in candidemia.