Candida Species

A 42-year-old man with acute leukemia undergoing chemotherapy develops fever (38.8°C), chills, and hypotension. Blood cultures are pending. Physical examination reveals no obvious source of infection. He is on broad-spectrum antibiotics for 5 days without improvement. What is the most appropriate next step in management?

All of the following are true regarding Candida albicans EXCEPT:

A 58-year-old man with acute leukemia undergoing induction chemotherapy develops fever (39.2°C), chills, and hypotension. Blood cultures are pending. Empiric broad-spectrum antibiotics were started 48 hours ago without improvement. Clinical examination reveals no focal infection. What is the most appropriate next step in management?

A 28-year-old man with acute leukemia undergoing chemotherapy develops persistent oral candidiasis unresponsive to fluconazole. Blood cultures are negative. Which investigation is most appropriate to assess for invasive candidiasis and identify the causative species?

A 34-year-old woman with poorly controlled type 2 diabetes mellitus (HbA1c 11.2%) presents with vulvovaginal itching, burning, and thick white vaginal discharge for 2 weeks. She denies fever or abdominal pain. On speculum examination, thick white plaques are seen adherent to the vaginal mucosa. Wet mount microscopy shows budding yeast and pseudohyphae. Culture on Sabouraud dextrose agar at 37°C grows white, creamy colonies. The isolate ferments glucose and maltose but not trehalose or lactose. What is the most likely causative organism?