Systemic candidiasis: a study of 109 fatal cases.

To gain further insight into the clinical features of systemic candidiasis in the compromised host, 109 fatal cases were studied during the 2 months prior to demise and by complete autopsy examination. Fever, granulocytopenia, relapse of the malignancy and therapy with antibiotics and immunosuppressive drugs comprise the clinical profile of approximately 90% of the patients. Eighty-eight percent of the patients had more than one deep organ affected, excluding mucosal lesions of the alimentary and respiratory tracts. Major organs involved in order of highest frequency were the lungs, spleen, kidneys, liver, heart and brain. Candida albicans was the causative agent in 91 cases and other Candida species were implicated in 18 of the cases. Antemortem cultures of 2858 specimens were of limited diagnostic aid. Concomitant infections were frequent and usually the cause of death.