Value of serum arabinitol for the management of Candida infections in clinical practice

To determine the value of serum arabinitol concentrations in clinical practice, we identified all patients at the University of Utah Medical Center for whom a serum arabinitol determination had been requested by the attending physician or housestaff to assist in the management of candidiasis. The patient populaton was divided into three categories on the basis of clinical and pathological findings: (1) superficial candidiasis, (2) possible deep, invasive candidiasis, and (3) definite, deep invasive candidiasis. Abnormal renal function was associated with elevated concentrations of serum arabinitol in proportion to the degree of renal dysfunction. Both the serum arabinitol concentration and the arabinitol/creatinine ratio were increased in the combined patient population with candidiasis relative to normal uninfected controls (p=0.06 and 0.001, respectively). However, neither of these tests reliably distinguished patients with invasive candidiasis from those with only superficial candidal disease.