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Candida albicans meningitis and brain abscesses in a neonate: a case report

Ingrid M Ancalle1, Juan A Rivera, Inés García

  • 1From the University of Puerto Rico School of Medicine, Department of Pediatrics, Neonatology Section, San Juan, Puerto Rico.

Boletin De La Asociacion Medica De Puerto Rico
|September 22, 2010
PubMed
Abstract

Insights

Neonatal candidemia can lead to serious complications like meningitis and brain abscesses. Early diagnosis with neuroimaging, such as MRI, is crucial for timely treatment in high-risk infants.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pediatric Neurology

Background:

  • Invasive Candida infections pose a significant threat in neonatal intensive care units, contributing to infant morbidity and mortality.
  • Neonatal candidemia affects 4-15% of extremely low birth weight infants, with meningitis occurring in 5-9% of these cases.
  • Cerebral abscesses are a rare but severe complication of Candida meningitis in neonates.

Observation:

  • A 34-week gestational age neonate presented with apnea and seizures at 12 days of age.
  • Cerebrospinal fluid (CSF) cultures identified Candida Albicans, while blood cultures remained negative.
  • Initial neuroimaging (ultrasound, CT) was unremarkable, but Brain MRI revealed multiple microabscesses in the brain parenchyma.

Findings:

  • Candida Albicans meningitis was diagnosed in a neonate based on CSF culture.
  • Brain Magnetic Resonance Imaging (MRI) was essential in detecting multiple cerebral microabscesses not visible on other imaging modalities.
  • The case highlights the diagnostic challenges of invasive fungal infections in neonates.

Implications:

  • This case underscores the importance of comprehensive cultures (blood, urine, CSF) when suspecting sepsis in neonates.
  • Neuroimaging, particularly advanced techniques like MRI, should be integral to the diagnostic workup for systemic fungal infections in infants.
  • Early detection of cerebral complications through improved neuroimaging can lead to prompt therapeutic interventions and potentially better outcomes.

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