Prognosis
Attributable mortality to candidemia ranges from 5% to 70%.[59] The following factors have been shown to influence that rate:
Clinical specifics related to the invasive Candida process (such as the presence of complications (e.g., endocarditis, central nervous system disease, septic shock)).
Host factors: acute physiology and chronic health evaluation (APACHE II score), neutropenia, and comorbidity, including underlying diseases (e.g., malignancy, diabetes mellitus, and other immunosuppressive disease and therapy).
Candida species responsible:[60][61] for example, C parapsilosis is usually an intravascular catheter-related pathogen that has lower morbidity and mortality. In contrast, a higher mortality has been attributed to C tropicalis and C glabrata.[8][62]
Timing and appropriateness of the antifungal therapy. Delay in therapy may increase mortality, with increased mortality associated with number of days that passed following notification of positive blood cultures for yeast.[38][39] Other factors include retention of a central venous culture and inadequate fluconazole dosing.[63]
Recognizing the importance of avoiding delay in instituting appropriate antifungal therapy, the Infectious Diseases Society of America has advised consideration for the early empiric use of broad-spectrum antifungal drugs (e.g., echinocandins) in febrile, non-neutropenic, high-risk intensive care unit patients failing to defervesce upon receipt of antibacterial agents, especially when cause of fever or sepsis is unknown.[22]
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