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[Multifocal Candida albicans osteoarthritis in an infant]
T Lamireau1, J Sarlangue, P Ohlbaum
1Service de pédiatrie néonatale et réanimation infantile, Hôpital des Enfants, Bordeaux, France.
Insights
A five-month-old experienced invasive candidal arthritis and osteomyelitis, a bone and joint infection. Prompt treatment led to a favorable prognosis, highlighting the importance of appropriate antifungal therapy.
Area of Science:
- Pediatric Infectious Diseases
- Mycology
- Skeletal Infections
Background:
- Invasive fungal infections, particularly candidal arthritis and osteomyelitis, pose significant risks in immunocompromised infants.
- Risk factors in this case included parenteral nutrition via central catheter, broad-spectrum antibiotics, and multiple gastrointestinal surgeries.
Observation:
- A five-month-old infant presented with symptoms indicative of invasive candidal infection affecting the joints and bones.
- The clinical presentation suggested a severe bone and joint infection requiring prompt diagnosis and management.
Findings:
- The case demonstrated a favorable prognosis for candidal arthritis and osteomyelitis with appropriate management.
- Monotherapy with 5-fluorocytosine was identified as suboptimal due to the high risk of rapid fungal resistance and therapeutic failure.
Implications:
- This case underscores the importance of early recognition and aggressive antifungal treatment for invasive candidal infections in neonates and infants.
- Judicious selection of antifungal agents is crucial to prevent the emergence of drug resistance in pediatric patients with serious fungal infections.
Abstract:
The authors report a case of candidal arthritis and osteomyelitis in a five-month-old child. Parenteral nutrition with central catheter, broad-spectrum antibiotherapy, repeated gastrointestinal surgery are the main risk factors. The prognosis for this bone and joint infection is favourable. Using 5-fluorocytosine alone is not recommended because of rapid gain of resistant various pathogenic fungi and the risk of therapeutic failure.