Darmstadt G L, Dinulos J G, Miller Z
Pediatrics. 2000 Feb;105(2):438-44. doi: 10.1542/peds.105.2.438.
We describe a term infant with congenital cutaneous candidiasis (CCC), and review all cases in the English literature that reported birth weight and outcome. Presence of an intrauterine foreign body was a predisposing factor for development of CCC and subsequent preterm birth. The most common presentation of CCC in neonates weighing >1000 g was a generalized eruption of erythematous macules, papules, and/or pustules that sometimes evolved to include vesicles and bullae. Extremely low birth weight, premature neonates weighing <1000 g most often presented with a widespread desquamating and/or erosive dermatitis (10 of 15 [67%]), and were at greater risk for systemic infection with Candida spp (10 of 15 [67%]) and death (6 of 15 [40%] than those weighing >1000 g (5 of 48 [10%]; 4 of 48 [8%], respectively). Systemic antifungal therapy is recommended for neonates with burn-like dermatitis attributable to Candida spp, or positive blood, urine, and/or cerebrospinal fluid cultures. Systemic treatment also should be considered for all infants with CCC who have respiratory distress in the immediate neonatal period and/or laboratory signs of sepsis such as an elevated leukocyte count with an increase in immature forms or persistent hyperglycemia and glycosuria.
我们描述了一名患有先天性皮肤念珠菌病（CCC）的足月儿，并回顾了英文文献中所有报告出生体重和结局的病例。宫内异物的存在是CCC发生及随后早产的一个诱发因素。体重>1000g的新生儿中，CCC最常见的表现是全身性红斑、丘疹和/或脓疱疹，有时会发展为包括水疱和大疱。极低出生体重儿，即体重<1000g的早产儿最常表现为广泛的脱屑和/或糜烂性皮炎（15例中有10例[67%]），与体重>1000g的新生儿相比（分别为48例中有5例[10%]；48例中有4例[8%]），其发生念珠菌属全身感染（15例中有10例[67%]）和死亡（15例中有6例[40%]）的风险更高。对于患有念珠菌属所致烧伤样皮炎、或血、尿和/或脑脊液培养呈阳性的新生儿，建议进行全身性抗真菌治疗。对于所有在新生儿早期出现呼吸窘迫和/或有败血症实验室体征（如白细胞计数升高伴未成熟细胞增多或持续性高血糖和糖尿）的CCC婴儿，也应考虑进行全身性治疗。
