Why Should We Monitor (1-3)--D-Glucan Levels during Invasive Candidiasis? Just Ask Your Ophthalmologist!

We read with great interest the article by Sims et al. pub-lished in a recent issue of the Journal of Clinical Microbi-ology (1), in which the authors established the usefulness of (1-3)--D-glucan (BG) serum measurement as a prognostic marker of treatment outcome, by correlating initial and final BG levels with the therapeutic responses in patients with proven invasive candidiasis (IC). Remarkably, a positive (de-crease) or negative (increase) slope in BG levels correlated, respectively, with the success or the failure of antifungal treat-ment. Unfortunately, few patients with hard-to-treat fungal infections (i.e., endophthalmitis, endocarditis, meningitis, os-teomyelitis) were studied (1). We agree with the authors in that baseline and consecutive serum BG determinations may be helpful in monitoring the response to treatment during IC, particularly for critically ill septic patients in whom the rapid clearance of fungal pathoge