Candidemia in patients with head and neck cancer: mortality and a novel risk factor

Kensuke Uraguchi, Takuma Makino, Shin Kariya, Youhei Noda, Hidenori Marunaka, Akira Doi, Kenichi Kozakura, Soshi Takao, Mizuo Ando

Research output: Contribution to journalArticlepeer-review


Purpose: Candidemia is a bloodstream infection (BSI) by Candida spp. and is associated with high mortality. However, there have been few reports about BSI in head and neck cancer (HNC). We aimed to evaluate the impact of candidemia in patients with HNC and compared it with bacteremia. Study design: A multicenter retrospective study. Methods: We retrospectively analyzed 83 BSI episodes in HNC (2011 to 2020) and divided them into the candidemia and bacteremia groups. We then compared the survival rate and risk factors for candidemia between the groups. Results: The overall cumulative incidence (risk) of candidemia in BSI was 12 out of 83 episodes (14.5%). The 1-year mortality for the bacteremia and candidemia groups was 33.3% and 58.3%, respectively (log-rank p = 0.041). Broad-spectrum antibiotics (odds ratio [OR]: 29.5; 95% confidence interval [CI], 2.49–350), mucositis (OR 11.0; 95% CI, 1.52–80.1), and malignant wounds (OR 79.5; 95% CI 1.33–4737) were significant risk factors for candidemia in HNC. Conclusions: Candidemia causes high mortality in patients with HNC. To our knowledge, malignant wounds have not been previously reported as a risk factor for candidemia. For early diagnosis and treatment of candidemia, risk factors should be considered, and antifungal therapy started earlier.

Original languageEnglish
Pages (from-to)5921-5930
Number of pages10
JournalSupportive Care in Cancer
Issue number7
Publication statusPublished - Jul 2022


  • Bacteremia
  • Bloodstream infection
  • Candidemia
  • Head and neck cancer
  • Malignant wounds

ASJC Scopus subject areas

  • Oncology


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