Ancalle Ingrid M, Rivera Juan A, García Inés, García Lourdes, Valcárcel Marta
From the University of Puerto Rico School of Medicine, Department of Pediatrics, Neonatology Section, San Juan, Puerto Rico.
Bol Asoc Med P R. 2010 Jan-Mar;102(1):45-8.
Invasive Candida infection is an increasingly important cause of morbidity and mortality in the neonatal intensive care unit. Neonatal candidemia occurs in 4-15% of extremely low birth weight infants. Meningitis occurs in 5-9% of patients with candidemia. A few infants with Candida meningitis (4%) present ventriculitis or brain abscess.
We report a neonate born at 34 weeks gestational age, who at 12 days old presented apnea and seizures. Cerebrospinal fluid (CSF) grew Candida Albicans, and blood cultures were negative. A head sonogram and head computed tomography scan were negative. Brain magnetic resonance imaging (MRI) detected multiple brain parenchyma micro abscesses.
This case confirms the need of obtaining adequate cultures including blood, urine, and CSF when sepsis is suspected. Neuroimaging studies should be included in diagnostic workup of patients with systemic fungal infection. Improved neuroimaging techniques such as MRI may lead to earlier diagnosis of cerebral abscesses.
