Candida infections sepsis

Amphotericin B remains the drug of choice in the treatment of invasive aspergillosis, locally invasive mucormycosis, and many disseminated fungal infections occurring in immunocompromised hosts (the patient population most at risk for serious fungal infections). For example, the febrile neutropenic oncology patient with persistent fever despite empirical antibacterial therapy is best treated with amphotericin B for possible Candida spp. sepsis. 

The effect of dexamethasone has been assessed in a retrospective chart review study in neonates weighing less than 1200 g, both with (n = 65) and without (n = 269) Candida sepsis dexamethasone therapy and prolonged antibiotic therapy were associated with Candida infection (342). 

Infants with SCID have profound immunodehciency and present with frequent episodes of diarrhea, pneumonia, otitis, sepsis, and cutaneous infections. Persistent infections with opportunistic organisms such as Pneumocystis carinii, Epstein-Barr virus, Candida albicans, cytomegalovirus, parainhuenzae 3 virus, respiratory syncitial virus, adenovirus, varicella, and bacille Calmette-Guerin (BCG) lead to death within the hrst or second year of life. ADA dehciency also occurs in adults, but with a much later onset and nhlder, but clinically discernible, immunodehciency [3,5]. 

In a rat model of neonatal sepsis, recombinant HL or talactoferrin was shown to improve survival (Venkatesh et al., 2007). In ex vivo studies, HL increased synergy of commonly used antibiotics against coagulase-negative staphylococcus and Candida (Venkatesh and Rong, 2008) and reduced biofilm of infected catheters (Venkatesh et al., 2009). 

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