ICU Map

Candidemia & Invasive Candidiasis — ICU Decision Pathway

ICU recognition and treatment of candidemia and invasive candidiasis, including source control, repeat cultures, step-down therapy and metastatic infection.

RecognizeAssessDecideDifferentialInterveneReassess
Persistent Fungemia / New Candidemia
Assessment StepTreat Candida in blood as invasive diseaseExplore Topic
Candida recovered from blood is clinically significant. Obtain repeat blood cultures daily or every other day until clearance; assess intravascular devices, abdominal sources and metastatic foci.
Clinical ActionStart an echinocandin in most critically ill adults
For candidemia in a critically ill adult, an echinocandin is preferred initial therapy. Fluconazole is an alternative only in selected stable patients unlikely to have azole-resistant species.
Reassessment / LoopReassess response and escalate
Trend physiology and organ function; if the patient is worsening, revisit diagnosis, source control and rescue options rather than repeating ineffective therapy.

An educational representation of clinical reasoning, not a diagnostic algorithm or personalized medical advice — always apply clinical judgment and institutional protocols.

Caution

Escalate — Red Flags & Critical Warnings

  • Escalate early for shock, rapidly progressive organ failure, dangerous ECG/airway findings or failure of initial therapy.

Related Bedside Clinical Problems (1)

Bedside Presentations
Persistent Fungemia / New Candidemia

Candida in blood is clinically significant: start appropriate antifungal therapy, document clearance, address intravascular/abdominal sources and determine duration from bloodstream clearance.

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Linked Deep-Dive Topics (1)

Reference Knowledge
Candidemia & Invasive Candidiasisinfectious-disease

ICU recognition and treatment of candidemia and invasive candidiasis, including source control, repeat cultures, step-down therapy and metastatic infection.

Explore Topic →

Evidence status

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