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Drug resistant neonatal Candida tropicalis septicemia. Did it cause diaphragmatic hernia?

Sourabh Dutta1, Anil Narang

  • 1Division of Neonatology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India. sourabhdutta@yahoo.com

Indian Pediatrics
|March 27, 2003
PubMed

Insights

A newborn developed invasive fungal infection (Candida tropicalis septicemia) resistant to common antifungals. The study discusses a potential link between the sepsis and an acquired diaphragmatic hernia, with successful treatment using 4-flucytosine and surgery.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Mycology

Background:

  • Early-onset invasive fungal infections pose significant risks in neonates.
  • Candida tropicalis is an opportunistic pathogen that can cause severe sepsis.
  • Antifungal resistance is a growing concern in treating neonatal candidiasis.

Observation:

  • A full-term neonate presented with Candida tropicalis septicemia.
  • The fungal isolate exhibited resistance to amphotericin B, fluconazole, and itraconazole.
  • The infant developed an acquired diaphragmatic hernia during the septic episode.

Findings:

  • Treatment with 4-flucytosine was initiated.
  • Surgical repair of the diaphragmatic hernia was performed.
  • The neonate showed clinical improvement following combined antifungal and surgical treatment.

Implications:

  • This case highlights the challenges of treating multidrug-resistant fungal sepsis in neonates.
  • The potential association between fungal sepsis and acquired diaphragmatic hernia warrants further investigation.
  • Multidisciplinary management involving infectious disease specialists and surgeons is crucial for favorable outcomes.

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