Candidal Meningitis in Neonates: A 10-Year Review

Abstract

Candidal meningitis may complicate systemic candidiasis in the premature neonate. We conducted a 10-year retrospective review of 106 cases of systemic candidiasis in neonates to define the incidence, clinical features, laboratory findings, treatment, and outcome of candidal meningitis. Twenty-three of the 106 neonates had candidal meningitis (0.4% of admissions to the neonatal intensive care unit). The median gestational age was 26.2 weeks, the median birth weight was 820 g, and the median age at the onset of illness was 8 days. Clinical disease was severe and commonly was manifested by respiratory decompensation. Findings of cerebrospinal fluid (CSF) analyses varied: pleocytosis was inconsistent, hypoglycorrhachia was common, gram staining was uniformly negative, and Candida was isolated from 17 neonates (74%). Each infant was treated with amphotericin B (median cumulative dose, 30 mg/kg); 5 also received flucytosine therapy. In conclusion, initial clinical features of candidal meningitis are indistinguishable from those of other causes of systemic infection in premature neonates, and normal CSF parameters do not exclude meningitis. Timely initiation of amphotericin B monotherapy was associated with an excellent outcome.

Neonatal Candida meningitis: significance of cerebrospinal fluid parameters and blood cultures

“…6,7 In a report by Faix et al, 8 only 50% (5/10) of the infants with culture-proven Candida meningitis had CSF WBC counts higher than 25 cells/mm 3 . A similar percentage of infants with elevated CSF WBC count (52%, 9/17) was observed in another cohort of infants with definite Candida meningitis, 9 and an even lower percentage (20%, 2/10) was found in another series. 10 In a recent multi-center study, 5% (14/293) of candidemic infants had Candida meningitis.…”

Fungal Granuloma following Endoscopic Third Ventriculostomy for Infantile Hydrocephalus = الورم الفطري الحبيبي بعد عملية التجويف الثالث بالمنظار لإستسقاء الرأس في الرضع

“…9 There was no other evidence of hydrocephalus being present antenatally or during the immediate post-natal period. The child had presented with a triventriculomegaly at a corrected age of one month and it was decided to perform an ETV based on the CT scan findings.…”

Fungal Infections in Newborn

“…Yaygın enfeksiyonu olan bebeklerde santral sinir sistemi tutulumu sıktır (%10-64) (34). Son yıllarda sıklığı, ampirik antifungal tedavi uygulamaları ve uygun tarama yöntemlerine bağlı olarak azalmıştır.…”