Table 1.

Candida BSI and sepsis

	Candida BSI	Candida Sepsis
Frequency	5–15% of all BSI	2–5% of sepsis cases, only a minority of Candida BSI proceed to severe forms of sepsis (see below)
Diagnostic criteria	Positive blood-culture for Candidaa	Systemic inflammatory response syndrom (SIRS) with 2 or more of the following symptoms: temperature <36°C or >38°C; heart rate >90/min; respiratory rate >20/min or PaCO2<32 mmHg; WBC <4×109/L or >12×109/L or ≥10% bands due to an infection with Candidac
Pathology	Dissemination of Candida in the bloodstream with/without affection of (multiple) organs presenting as “acute disseminated candidiasis” or “chronic disseminated candidiasis” with the latter mainly occurring in neutropenic patients.	Clinical presentation is dominated by severe dysregulation of immunity, coagulation and circulation. In progressive disease this results in organ failure (“severe sepsis”) and cardial decompensation (“septic shock”).
Associated mortality	< 30–40%b, 6–8	∼70%5 septic shock complicating Candida BSI is “a near fatal condition”18

Note: ^aOther diagnostic tests may also be indicative, e.g., PCR based detection in blood, β-glucan testing. ^bThese are mortality rates from case series of Candida BSI including patients with sepsis, severe sepsis or septic shock; so fatality rates for Candida BSI without sepsis will be lower. ^cCurrently, several authors suggest to rephrase sepsis definitions and restrict sepsis to cases with resulting organ failure.¹⁹