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Severe Congenital Candidiasis due to Candida dubliniensis Treated With Fosfluconazole in a Preterm Infant

Hiroyuki Higashiyama1, Takeshi Futatani1

  • 1Department of Neonatology, Toyama Prefectural Central Hospital, Toyama, Japan, tch.pref.toyama.jp.

Case Reports in Pediatrics
|April 29, 2026
PubMed

Insights

Severe congenital candidiasis caused by Candida dubliniensis in a preterm infant was successfully treated with micafungin after fluconazole failure. This case highlights the need for alternative antifungals when C. dubliniensis is involved.

Area of Science:

  • Neonatology
  • Mycology
  • Infectious Diseases

Background:

  • Congenital candidiasis is a rare, severe neonatal infection.
  • Candida albicans is the usual pathogen; Candida dubliniensis has not been previously reported.
  • Preterm infants are particularly vulnerable.

Purpose of the Study:

  • To report a case of severe congenital candidiasis caused by Candida dubliniensis.
  • To describe the treatment and outcome in a very low-birth-weight infant.
  • To discuss the implications for antifungal therapy.

Main Methods:

  • Case report of a very low-birth-weight infant with congenital candidiasis.
  • Initial treatment with intravenous fosfluconazole.
  • Switch to intravenous micafungin following relapse.
  • In vitro experiments on fluconazole resistance in C. dubliniensis.

Main Results:

  • The infant experienced a relapse after fosfluconazole treatment.
  • Micafungin treatment was successful, with no further relapse.
  • The patient was discharged without sequelae.
  • In vitro studies showed stable fluconazole resistance in C. dubliniensis.

Conclusions:

  • Candida dubliniensis can cause severe congenital candidiasis.
  • Micafungin may be an effective alternative to fluconazole for C. dubliniensis infections.
  • Consider alternative antifungal agents for C. dubliniensis due to potential fluconazole resistance.

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