"Amber in chamber" an enigmatous right atrial mass in a neonate

Sanjay Kumar1, Jai Prakash Sharma2, Saurabh Saigal3

  • 1Department of Anesthesia, AIIMS, New Delhi, India.

Insights

Neonatal fungal infection is rare but serious. Early echocardiography in preterm infants with sepsis can reveal fungal balls, enabling prompt treatment and improving survival rates.

Area of Science:

  • Neonatology
  • Pediatric Infectious Diseases
  • Medical Mycology

Background:

  • Fungal infections are increasingly prevalent globally, yet uncommon in neonates.
  • Preterm neonates present unique challenges for diagnosis and management of infections.

Observation:

  • A 34-week preterm neonate developed respiratory distress and sepsis despite treatment.
  • Echocardiography identified a large right atrial mass, later confirmed as a fungal ball.

Findings:

  • The fungal ball in the right atrium was the source of the severe neonatal septicemia.
  • Prompt surgical and medical intervention led to the neonate's rapid recovery.

Implications:

  • Echocardiography is crucial for diagnosing atypical neonatal septicemia, especially in preterm infants.
  • Early identification of fungal infections via echocardiography can significantly improve patient outcomes.
  • This case highlights the importance of considering fungal etiologies in refractory neonatal sepsis.

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