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[Severe infection caused by Candida parapsilosis in an infant]

J Bosch Mestres1, M Esque Ruiz, X Carbonell Estrany

  • 1Laboratorio de Microbiología, Departamento de Pediatría, Casa de Maternitat, Barcelona.

Insights

Serious Candida parapsilosis infections in infants, often linked to catheters, require prompt intervention. Treatment involves catheter replacement and amphotericin B, though relapses can occur.

Area of Science:

  • Medical Mycology
  • Pediatric Infectious Diseases
  • Critical Care Medicine

Background:

  • Candida parapsilosis is an emerging cause of serious infections in neonates and infants.
  • Infants with indwelling devices and prior antibiotic exposure are at increased risk.

Observation:

  • Three infant cases of invasive Candida parapsilosis infections are presented.
  • Two infants developed catheter-associated sepsis following abdominal surgery, parenteral nutrition, and antibiotics.
  • One infant with a cerebrospinal fluid shunt developed meningitis.

Findings:

  • Catheter-associated sepsis responded to catheter replacement and intravenous amphotericin B, with one relapse.
  • Cerebrospinal fluid infection showed no response to antifungal therapy, leading to mortality.
  • Risk factors identified include intravascular/intraventricular catheters and prior medical interventions.

Implications:

  • Early recognition and management of Candida parapsilosis are crucial in high-risk infants.
  • Catheter management and appropriate antifungal therapy, such as amphotericin B, are key treatment strategies.
  • Meningitis cases may have a poorer prognosis, highlighting the need for vigilant monitoring and potentially novel therapeutic approaches.

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