Congenital cutaneous candidiasis associated with maternal peripartum candidemia.
Adult
Antifungal Agents
/ therapeutic use
Candidemia
/ drug therapy
Candidiasis, Cutaneous
/ congenital
Candidiasis, Vulvovaginal
/ drug therapy
Continuous Positive Airway Pressure
Female
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical
Lung Diseases, Fungal
/ congenital
Maternal-Fetal Exchange
Pregnancy
Pregnancy Complications, Infectious
/ drug therapy
Puerperal Disorders
/ drug therapy
Vacuum Extraction, Obstetrical
Candidemia
Candidiasis congénita cutánea
Congenital cutaneous candidiasis
Infección materna periparto
Infección neonatal
Maternal peripartum infection
Neonatal infection
Journal
Revista iberoamericana de micologia
ISSN: 2173-9188
Titre abrégé: Rev Iberoam Micol
Pays: Spain
ID NLM: 9425531
Informations de publication
Date de publication:
Historique:
received:
10
12
2019
revised:
01
02
2020
accepted:
21
02
2020
pubmed:
5
6
2020
medline:
26
10
2021
entrez:
5
6
2020
Statut:
ppublish
Résumé
Cutaneous congenital candidiasis (CCC) is a rare condition consisting of invasive fungal infection of the epidermis and dermis that mostly affects preterm infants. Maternal vaginal candidiasis is present in half of the cases, although the occurrence of invasive candidiasis during pregnancy or peripartum period is exceptional. We present the case of a full-term infant that was born by vacuum-assisted vaginal delivery to an apparently healthy 33 year-old woman with no history of intravenous drug use or vaginal candidiasis during pregnancy. The newborn showed a diffuse maculopapular rash with respiratory distress and bilateral interstitial lung infiltrates, requiring nasal continuous positive airway pressure support. Blood cultures obtained from the mother due to intrapartum fever yielded Candida albicans. Cultures of vaginal discharge and neonate skin also yielded C. albicans with the same in vitro susceptibly pattern. No alternative source for candidemia was identified. The clinical course after starting a systemic antifungal therapy was favorable in both the mother and the neonate, with clearance of candidemia and resolution of the skin lesions. CCC must be considered in full-term newborns with maculopapular rash at birth or during the first days of life. The absence of alternative sources for bloodstream infection in the present case suggests a potential etiopathogenic relationship between CCC and maternal candidemia. It is reasonable to rule out postpartum candidemia when CCC is suspected.
Sections du résumé
BACKGROUND
BACKGROUND
Cutaneous congenital candidiasis (CCC) is a rare condition consisting of invasive fungal infection of the epidermis and dermis that mostly affects preterm infants. Maternal vaginal candidiasis is present in half of the cases, although the occurrence of invasive candidiasis during pregnancy or peripartum period is exceptional.
CASE REPORT
METHODS
We present the case of a full-term infant that was born by vacuum-assisted vaginal delivery to an apparently healthy 33 year-old woman with no history of intravenous drug use or vaginal candidiasis during pregnancy. The newborn showed a diffuse maculopapular rash with respiratory distress and bilateral interstitial lung infiltrates, requiring nasal continuous positive airway pressure support. Blood cultures obtained from the mother due to intrapartum fever yielded Candida albicans. Cultures of vaginal discharge and neonate skin also yielded C. albicans with the same in vitro susceptibly pattern. No alternative source for candidemia was identified. The clinical course after starting a systemic antifungal therapy was favorable in both the mother and the neonate, with clearance of candidemia and resolution of the skin lesions.
CONCLUSIONS
CONCLUSIONS
CCC must be considered in full-term newborns with maculopapular rash at birth or during the first days of life. The absence of alternative sources for bloodstream infection in the present case suggests a potential etiopathogenic relationship between CCC and maternal candidemia. It is reasonable to rule out postpartum candidemia when CCC is suspected.
Identifiants
pubmed: 32493666
pii: S1130-1406(20)30019-X
doi: 10.1016/j.riam.2020.02.002
pii:
doi:
Substances chimiques
Antifungal Agents
0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
68-71Informations de copyright
Copyright © 2020 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.