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Candidaemia — SCE Infectious Diseases MCQ

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HardFungal InfectionsCandidaemiaSCE Infectious Diseases

A 42-year-old man receiving induction chemotherapy for AML develops persistent fever despite broad-spectrum antibiotics and antifungals. Blood cultures taken through a Hickman line grow Candida parapsilosis. What is a critical element of management specific to this organism?

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Correct answer: C — Central venous catheter removal

C. parapsilosis has a strong association with biofilm formation on intravascular catheters. While echinocandin MICs for C. parapsilosis are higher than for C. albicans, clinical outcomes with echinocandins are generally acceptable if the catheter is removed. Catheter removal is a critical and general recommendation for all candidaemia, but it is especially important with C. parapsilosis given the biofilm association. Fluconazole is often preferred for step-down in susceptible C. parapsilosis due to lower echinocandin activity.

Reference: ESCMID 2024 – Candida guidelines; IDSA 2016 – Candidiasis guidelines