American Board of Internal Medicine (ABIM) Certification Practice Exam

Which condition may lead to metastatic complications if candidemia is not treated?

1. Candidiasis of the skin

2. Endophthalmitis, endocarditis, or osteomyelitis

3. Hematologic malignancies

4. Immunocompromised status

The correct answer is: Endophthalmitis, endocarditis, or osteomyelitis

Candidemia, which is the presence of Candida species in the bloodstream, can indeed lead to serious metastatic complications, particularly if it is not addressed promptly. One of the significant risks associated with untreated candidemia is the development of endophthalmitis, endocarditis, and osteomyelitis. Endophthalmitis is an inflammatory condition of the inside of the eye and can arise from the hematogenous spread of Candida species, leading to vision loss and other complications. Endocarditis, an infection of the heart valves, can result from the embolization of Candida organisms into the heart, potentially leading to acute complications or chronic heart disease. Osteomyelitis, an infection in the bone, can occur when Candida spreads through the bloodstream and settles in the skeletal system. The other conditions mentioned do not directly correspond to the immediate risks associated with untreated candidemia. Candidiasis of the skin may indicate a superficial infection that generally does not lead to metastasis in the same way that bloodstream infections do. Hematologic malignancies and immunocompromised status are risk factors for developing candidemia rather than complications arising directly from it. While these conditions may increase susceptibility to infections, they do not inherently lead to metastatic issues stemming from untreated candid