Candida pneumonia in a term infant after prolonged use of inhaled corticosteroids for bronchopulmonary dysplasia (BPD)

Buzzi, Eleonora; Manzoni, Paolo; Castagnola, Elio; Benjamin, Daniel K.; Beghini, Renzo; Dall’Agnola, A

doi:10.1016/s0378-3782(13)70018-5

Cited by 5 publications

(3 citation statements)

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“…Adults receiving inhaled corticosteroids have an increased pneumonia risk [33]. A recent case report described a term infant who developed Candida pneumonia after being treated with inhaled steroids [34] and a case series described inhaled steroid-associated tongue hypertrophy [35]. Future pharmacoepidemiology studies are needed to assess side effects [36], [37].…”

Section: Discussionmentioning

confidence: 99%

Utilization of Inhaled Corticosteroids for Infants with Bronchopulmonary Dysplasia

et al. 2014

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ObjectiveTo determine demographic and clinical variables associated with inhaled corticosteroid administration and to evaluate between-hospital variation in inhaled steroid use for infants with bronchopulmonary dysplasia (BPD).DesignRetrospective Cohort Study.SettingNeonatal units of 35 US children's hospitals; as recorded in the Pediatric Health Information System (PHIS) database.Patients1429 infants with evolving BPD at 28 days who were born at <29 weeks gestation with birth weight <1500 grams, admitted within the first 7 postnatal days, and discharged between January 2007–June 2011.ResultsInhaled steroids were prescribed to 25% (n = 352) of the cohort with use steadily increasing during the first two months of hospitalization. The most frequently prescribed steroid was beclomethasone (n = 194, 14%), followed by budesonide (n = 125, 9%), and then fluticasone (n = 90, 6%). Birth gestation <24 weeks, birth weight 500–999 grams, and prolonged ventilation all increased the adjusted odds of ever receiving inhaled corticosteroids (p<0.05). Wide variations between hospitals in the frequency of infants ever receiving inhaled steroids (range: 0–60%) and the specific drug prescribed were noted. This variation persisted, even after controlling for observed confounders.ConclusionsInhaled corticosteroid administration to infants with BPD is common in neonatal units within U.S. Children's hospitals. However, its utilization varies markedly between centers from no treatment at some institutions to the majority of infants with BPD being treated at others. This supports the need for further research to identify the benefits and potential risks of inhaled steroid usage in infants with BPD.

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Section: Discussionmentioning

confidence: 99%

Utilization of Inhaled Corticosteroids for Infants with Bronchopulmonary Dysplasia

et al. 2014

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“…Candida spp. [13,14,16,18] Severe oropharyngeal candidiasis, esophagitis, candidiasis of trachea and bronchi. Pulmonary candidiasis secondary to tracheobronchial infection is not considered as possible outside some specific neonatal conditions.…”

Section: Fungi Clinical Conditionmentioning

confidence: 99%

Definition of Opportunistic Infections in Immunocompromised Children on the Basis of Etiologies and Clinical Features: A Summary for Practical Purposes

Riccardi

Rotulo

Castagnola

2019

CPR

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: Opportunistic Infections (OIs) still remain a major cause of morbidity and death in children with either malignant or nonmalignant disease. : OIs are defined as those infections occurring due to bacteria, fungi, viruses or commensal organisms that normally inhabit the human body and do not cause a disease in healthy people, but become pathogenic when the body's defense system is impaired. OIs can also be represented by unusually severe infections caused by common pathogens. An OI could present itself at the onset of a primary immunodeficiency syndrome as a life-threatening event. More often, OI is a therapyassociated complication in patients needing immunosuppressive treatment, among long-term hospitalised patients or in children who undergo bone marrow or solid organ transplantation. : The aim of the present review is to provide a comprehensive and ‘easy to read’ text that briefly summarises the currently available knowledge about OIs in order to define when an infection should be considered as opportunistic in pediatrics as a result of an underlying congenital or acquired immune-deficit.

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“…Other possible, less frequent sites of localizations are endocarditis, endophthalmitis, liver and spleen abscesses, osteoarthritis, intestine with perforation secondary to candidemia, kidneys usually associated with urinary obstruction from fungal bezoar, especially in patients affected by urinary tract malformation [ 1 ]. Candida pneumonia is generally hematogenous, and lung infection due to fungal aspiration is very rare and can be observed only in neonates with reflux and oro-pharyngeal secretions aspirations [ 16 ]. Finally, in addition to damages associated with deep organ localizations, candidemia has been associated with long-term sequelae such as preterm retinopathy or neurological impairment.…”

Section: Introductionmentioning

confidence: 99%

Prophylaxis of Invasive Fungal Infection in Neonates: A Narrative Review for Practical Purposes

Ferrando

Castagnola

2023

JoF

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Candida albicans is the most frequent cause of invasive fungal disease in preterm and/or low birth weight neonates, followed by Candida parapsilosis, whilst infections from other species are rare. Considering the severity of the disease, associated with poor clinical signs and diagnostic difficulties, primary prophylaxis becomes relevant. This paper summarizes the pathogenesis and clinical presentation of invasive candidiasis in neonates, focusing on prophylaxis. For late onset invasive disease, e.g., those occurring after the 3rd (or 7th according to some definitions) day of life possible approaches are the use of fluconazole, recommended in case of weight <1000 g or <1500 g if the local incidence of invasive candidiasis is higher than 2%, or the use of nystatin (for patients < 1500 g). Micafungin must be used in case of colonization by Candida auris, or in centers with a high prevalence of this pathogen. Concurrently, correct management of the central venous catheter and isolation procedures, with special regard to patients colonized by resistant strains, are fundamental. Other approaches such as reduced use of H2 blockers and broad-spectrum antibiotics (e.g., 3rd generation cephalosporins or carbapenems) and promotion of breast feeding proved useful. Reduction of early-onset infections (those occurring in the first 3 days of life) can also be obtained by treating maternal vulvo–vaginal candidiasis, which can represent a fastidious problem during pregnancy. In this case, topic azoles (the only recommendable treatment) can represent a kind of “prophylaxis” of early neonatal candidiasis. However, it must always be remembered that prophylaxis reduces the risk of invasive candidiasis but can not completely eliminate its occurrence, with the parallel risk of selecting for antifungal-resistant strains. Clinicians must maintain a high level of suspicion to start an appropriate therapy and strict epidemiological surveillance to identify the occurrence of clusters and the appearance of strains resistant to prophylaxis.

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Candida pneumonia in a term infant after prolonged use of inhaled corticosteroids for bronchopulmonary dysplasia (BPD)

Cited by 5 publications

References 5 publications

Utilization of Inhaled Corticosteroids for Infants with Bronchopulmonary Dysplasia

Utilization of Inhaled Corticosteroids for Infants with Bronchopulmonary Dysplasia

Definition of Opportunistic Infections in Immunocompromised Children on the Basis of Etiologies and Clinical Features: A Summary for Practical Purposes

Prophylaxis of Invasive Fungal Infection in Neonates: A Narrative Review for Practical Purposes

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