• G Kaltenbach, T Vogel, M Noblet-Dick, D Heitz, M Berthel, and F Kuntzmann.
• Centre de gérontologie des hôpitaux universitaires de strasbourg, hôpital de la Robertsau, 83, rue Himmerich, 67091 Strasbourg, France. Georges.Kaltenbach@chru-strasbourg.fr
• Rev Med Interne. 2002 Mar 1; 23 (3): 328-31.

IntroductionCandidemia, principally affecting neutropenic patients in departments of oncohematology and frail patients in intensive care units, can also be observed in frail elderly people in geriatrics.ExegesisAuthors report four observations of candidemia diagnosed in elderly dependent patients having several different diseases. Clinical sign was a persistent or recurrent fever after a wide-spectrum antibiotic therapy. Patients were treated by fluconazole leading to negative blood cultures in several days. Three out of four patients died within the weeks following antifungal therapy due to severity of associated diseases.ConclusionThese observations show that a diagnosis of candidemia should be made when a persistent fever is observed in a frail elderly person. Fluconazole, as efficient as amphotericin B and well tolerated by elderly people, should be the first treatment of candidemia in non-neutropenic patients.

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