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Published on: September 15, 2014
Challenging neonatal central nervous system fungal infection diagnosed by MRI: a case report
Hanin Shatrit1, Salahaldeen Deeb1, Motaz Tamimi2
1Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Background:
Although central nervous system fungal infection (CNSF) is uncommon, it is a life-threatening condition that requires prompt diagnosis and management. Here, we report a full-term female neonate with suspected CNSF diagnosed by magnetic resonance imaging (MRI) despite repeatedly negative cerebrospinal fluid (CSF) and blood cultures, in whom the causative pathogen could not be identified.
Case Presentation:
A full-term female neonate presented on the first day of life with irritability, hypoactivity, cyanosis, poor feeding, and two episodes of generalized tonic-clonic seizures with up-rolling of the eyes and lip smacking. Workup for neonatal sepsis showed negative CSF and blood cultures. MRI findings suggested CNSF, and treatment was initiated with low-dose conventional amphotericin B deoxycholate (0.5 mg/kg/day) for 4 weeks, leading to complete clinical and radiological resolution.
Conclusion:
Negative CSF and blood cultures do not exclude neonatal CNSF. In resource-limited settings, MRI findings together with clinical response to antifungal therapy may support a diagnosis of probable CNSF, even when the pathogen is not identified and standard high-dose regimens are not available.
Insights
Central nervous system fungal infection (CNSF) in neonates can be life-threatening. Magnetic resonance imaging (MRI) and clinical response to antifungal therapy can aid diagnosis, even with negative cultures.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Medical Imaging
Background:
- Central nervous system fungal infection (CNSF) is a rare but severe condition in neonates.
- Prompt diagnosis and management are critical for favorable outcomes.
- Identifying the causative pathogen can be challenging, especially in newborns.
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