Abstract
Background: Candida species are becoming one of the most common pathogens associated with nosocomial infection in the neonatal intensive care units (NICU). This study was undertaken to investigate clinical features and radiologic findings of meningitis complicating candida sepsis in the neonates.
Methods: Eighty-seven neonates with candida sepsis were enrolled who were admitted in the NICU of Dongsan Medical Center, Keimyung University from Jan. 1997 to Dec. 2004. Retrospective analysis of the medical records and radiologic images performed.
Results: The commom species of candida sepsis were C. albicans (62%), C. parapsilosis (27%) and others such as C. guilliermondi(7%), C. glabrata (2%) and C. tropicalis (2%), and CNS involvement developed in 13(15%) of the 87 patients. Almost all the causative organism was C. albicans (92%) and the other was C. parapsilosis (8%) in 13 cases with meningitis. Findings of CSF study at the early stage of infection were variable: pleocytosis showed in 10(77%), elevated protein and candidal isolation in 7(54%) respectively, and hypoglycorrhachia was inconsistent. Between the two groups of patients who had candida sepsis (group 1: with meningitis, group 2: without meningitis), demographic characteristics were similar distribution, but fever or seizure at onset of infection was more common in group 1 (P<0.05). Also, mortality rate was higher in group 1, but statistically not significant. Cerebral microabscesses showed in 10(91%) in 11 cases with serial ultrasound examinations and 7(78%) in 9 cases with magnetic resonance studies which were performed at late time. Common complications of amphotericin-B therapy were hypokalemia, thrombocytopenia and anemia but usually reversible.
Conclusions: Candida meningitis is common in neonates with C. albicans sepsis (P<0.05) and findings of CSF study were variable so that serial ultrasound examinations may help in the correct diagnosis of CNS involvement.
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Kim, C., Lee, S. & Lee, H. 201 Clinical Features and Radiologic Findings in Neonatal Candida Meningitis: A 8-Year Experience. Pediatr Res 58, 389 (2005). https://doi.org/10.1203/00006450-200508000-00230
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DOI: https://doi.org/10.1203/00006450-200508000-00230