American Board of Internal Medicine (ABIM) Certification Practice Exam

When should a patient with detected candidemia be treated?

1. After seeing symptoms improve

2. Immediately upon diagnosis

3. Only if fever persists

4. After 2 days of observation

The correct answer is: Immediately upon diagnosis

In cases of candidemia, which is a bloodstream infection caused by Candida species, prompt treatment is crucial. The rationale for immediate intervention stems from the potential severity of the condition, which can lead to serious complications, including disseminated intravascular coagulation, organ dysfunction, sepsis, and increased mortality if left untreated. Initiating antifungal therapy immediately upon diagnosis allows for quicker control of the infection and can significantly improve outcomes for the patient. Delaying treatment until symptoms improve, fever persists, or after a period of observation poses the risk of the infection worsening, and thus a timely response to a confirmed diagnosis of candidemia is essential. Thus, beginning treatment immediately upon diagnosis is the best practice in managing candidemia to mitigate its associated risks and enhance the chances of recovery.