skip to main content

Deep Candida Sternal Infection — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

HardFungal InfectionsDeep Candida Sternal InfectionSCE Infectious Diseases

A 50-year-old man develops a deep sternal wound infection after cardiac surgery. Cultures grow Candida albicans from deep tissue samples (multiple positive cultures). He has risk factors: prolonged ICU stay, broad-spectrum antibiotics, TPN, and central venous catheter. What management is required?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Surgical debridement plus systemic antifungal therapy (echinocandin then step-down to Fluconazole if susceptible) for at least 6 weeks — deep Candida wound infection post-cardiac surgery is a serious complication

Deep Candida sternal wound infection after cardiac surgery (distinct from superficial colonisation) requires: surgical debridement ± VAC therapy, systemic antifungal therapy (echinocandin initially — better coverage of potential resistant species; step-down to Fluconazole if C. albicans confirmed susceptible), and management of risk factors (TPN rationalisation, catheter review, antibiotic de-escalation). Treatment duration is at least 6 weeks given the deep tissue/sternal involvement. Multiple positive deep tissue cultures distinguish genuine infection from colonisation.

Reference: ESCMID 2024 – Candida; NICE NG125 2020 – SSI; IDSA 2016