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The inflammatory response in candidal chorioamnionitis.

I C Hood, D J Desa, R K Whyte

    Human Pathology
    |November 1, 1983
    PubMed
    Summary
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    Fetal infection with Candida, known as candidal funisitis, is rare but presents distinct umbilical cord plaques. The fetus can mount an immune response to Candida as early as 18 weeks gestation.

    Area of Science:

    • Perinatal pathology
    • Fungal infections
    • Immunology

    Background:

    • Fetal Candida infections are infrequently documented.
    • Chorioamnionitis cases provide insight into fetal responses.
    • Umbilical cord and placental examination is crucial.

    Purpose of the Study:

    • To characterize the pathological features of fetal Candida infection.
    • To investigate the fetal immune response to Candida organisms.
    • To identify diagnostic markers for candidal funisitis.

    Main Methods:

    • Examination of umbilical cords and placentas from 23 chorioamnionitis cases.
    • Utilized electron microscopy and immunoperoxidase staining.
    • Histopathological analysis of fetal tissue lesions.

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    Main Results:

    • Distinctive pale yellow plaques on umbilical cords indicated candidal funisitis.
    • Lesions were focal, subamniotic, embedded in exudate, and surrounded by inflammatory cells.
    • Immunoperoxidase staining revealed IgG, IgM, and IgA in lesions, originating from inflammatory cells.
    • Two cases of fetal giant cell pneumonitis suggested an early fetal immune response (from 18 weeks gestation).

    Conclusions:

    • Candidal funisitis has characteristic gross and histopathological findings.
    • The fetus demonstrates an inflammatory and immune response to Candida, including IgA production in the lung.
    • Early gestational immune response to Candida is possible.