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Candidaemia Duration — SCE Infectious Diseases MCQ

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ModerateHealthcare-Associated InfectionsCandidaemia DurationSCE Infectious Diseases

A 62-year-old man with a tunnelled Hickman line for TPN develops a catheter-related bloodstream infection with Candida parapsilosis. The line has been in situ for 6 months. Blood cultures clear after 48 hours of Caspofungin and line removal. What is the minimum duration of antifungal therapy?

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Correct answer: C — 14 days from the first negative blood culture

For uncomplicated candidaemia (no metastatic complications, ophthalmological examination negative, line removed, blood cultures clearing promptly), the minimum antifungal treatment duration is 14 days from the first negative blood culture. An ophthalmological examination (dilated fundoscopy) must be performed to exclude Candida endophthalmitis, which would extend treatment. Follow-up blood cultures should be taken to confirm clearance. Echocardiography should be considered to exclude endocarditis, particularly with prolonged candidaemia.

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