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先天性念珠菌病极早产儿的成功管理。

Successful management of an extremely premature infant with congenital candidiasis.

作者信息

Iwatani Sota, Murakami Yuko, Mizobuchi Masami, Fujioka Kazumichi, Wada Keiko, Sakai Hitomi, Yoshimoto Seiji, Nakao Hideto

机构信息

Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Suma-Ku, Kobe-Shi, Hyogo, Japan ; These authors contributed equally to this work.

Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Suma-Ku, Kobe-Shi, Hyogo, Japan ; Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Kita-Ku, Okayama-Shi, Okayama, Japan ; These authors contributed equally to this work.

出版信息

AJP Rep. 2014 May;4(1):5-8. doi: 10.1055/s-0033-1358766. Epub 2013 Dec 12.

Abstract

Congenital candidiasis, which presents with a variety of clinical symptoms, is very rare in both term and preterm infants, and less than 100 neonatal cases have been reported in the medical literature. We describe the case of an extremely premature infant with congenital candidiasis, who was successfully treated and survived without major sequelae. A male infant was born at 25 weeks' gestation (weight, 834 g). He exhibited diffuse erythematous papules. Samples of his skin, pharyngeal mucus, gastric fluid, and tracheal aspirate were found to be Candida albicans-positive while blood cultures were negative. Further histopathological examinations revealed that Candida albicans mycelia had invaded the umbilical cord. After prompt antifungal therapy, the patient's skin lesions improved markedly, and he was discharged from hospital without any major complications. This report highlights the importance of characteristic skin lesions for the early diagnosis of Candida infections, especially in extremely premature infants.

摘要

先天性念珠菌病临床表现多样,在足月儿和早产儿中均极为罕见,医学文献报道的新生儿病例不足100例。我们描述了一例患有先天性念珠菌病的极早产儿,经成功治疗后存活且无严重后遗症。一名男婴在孕25周时出生(体重834克)。他出现了弥漫性红斑丘疹。其皮肤、咽黏液、胃液和气管吸出物样本检测显示白色念珠菌呈阳性,而血培养为阴性。进一步的组织病理学检查发现白色念珠菌菌丝已侵入脐带。经过及时的抗真菌治疗,患者的皮肤病变明显改善,出院时无任何重大并发症。本报告强调了特征性皮肤病变对念珠菌感染早期诊断的重要性,尤其是在极早产儿中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78e7/4078183/ac08eafa2368/10-1055-s-0033-1358766-i130020-1.jpg

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