In order to elucidate the background of candida infection in patients with pulmonary disease, we divided 100 patients into 2 groups according to their serum titer of CAND-TEC determined by latex agglutination test for candida antigen. Group C1 (83 patients) had CAND-TEC value less than 2:1, and Group C2 (17 patients) had CAND-TEC value greater than 4:1. There was a significantly higher incidence of respiratory failure, hypoalbuminemia, and fever unresponsive to antibiotics in Group C2 compared with Group C1. Regarding the sputum culture of candida, there were significantly more positive cases in Group C2 than in Group C1. Furthermore, Group C2 showed a significantly poorer prognosis than Group C1. Generally, the candida antigen titer correlated well with clinical findings and with the course of infection and treatment with antifungal drugs. These results suggest that administration of antifungal drugs may be indicated in patients with fever unresponsive to antibiotics when the candida antigen titer is greater than 4:1.
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