Asymptomatic Vaginal Candidiasis Complicated by Chorioamnionitis and Pelvic Abscess at Full-Term Delivery: A Case...

Despite the high frequency of vaginal candidiasis during pregnancy, chorioamnionitis (CAM) is rarely caused by Candida species as the initiating organism, especially in full-term delivery. A 25-year-old Japanese woman was referred to our hospital at 34 weeks and two days of gestation and was diagnosed with vaginal candidiasis based on a vaginal culture examination. She delivered a newborn via cesarean section at 39 weeks and four days of gestation. The newborn had scattered erythematous small papules systemically. White patches were observed on the placental fetal surface and along the entire length of the umbilical cord. Amniotic fluid and cord blood cultures revealed the presence of Candida albicans. An antifungal agent was administered to the mother and newborn. Surgical drainage was required for the treatment of the intra-abdominal abscess of the mother. Placental pathology revealed histological CAM and funisitis, with a maternal inflammatory response of Stage 3/Grade 2 and a fetal inflammatory response of Stage 3/Grade 2. Periodic acid-Schiff stain demonstrated fungal yeasts in the amniotic membrane or near the surface of the umbilical cord. Asymptomatic vaginal candidiasis can lead to maternal and neonatal development of disease due to CandidaCAM in the peripartum period even in full-term pregnancy. Especially in cesarean delivery, physicians should pay attention to postoperative pelvic abscess formation.