Bradycardia as an early sign of systemic candidiasis

Abstract

The diagnosis of systemic candidiasis remains a difficult problem, especially in the surgical intensive care unit patient. It would be clinically advantageous to make the diagnosis prior to the patient showing signs of sepsis or multiple organ failure. We report four cases in which unexplained bradycardia was used as the indication for the initiation of amphotericin B prior to positive blood cultures for Candida. Ultimately, the blood cultures did turn positive. We suggest that these recurrent unexplained bradycardic episodes may be an indication for the initiation of amphotericin B therapy, or at least a more aggressive search for Candida infection.