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Candida antigen detection in two premature neonates with disseminated candidiasis
Abstract:
Two premature neonates with birth weight less than 1,200 g developed systemic candidiasis during treatment with multiple antibiotics and parenteral hyperalimentation. Clinical findings included signs of necrotizing enterocolitis in one patient and multiple fungal renal cortical abscesses in the other. The Candida antigen, mannan, was present in the sera of both patients at the time of clinical deterioration. Multiple blood cultures and urine and stool samples from both patients grew Candida albicans. Systemic antifungal therapy was given for a 6-week period and was associated with prolonged antigenemia despite negative findings on follow-up cultures. Antifungal therapy was stopped soon after antigen was no longer detected. Both patients recovered without evidence of further fungal infection. Candida antigen detection may be useful in the diagnosis and follow-up of premature infants with disseminated candidiasis.
Insights
Candida antigen detection aids in diagnosing systemic candidiasis in premature infants. Monitoring Candida antigen levels helps guide antifungal therapy and confirms recovery in these vulnerable neonates.
Area of Science:
- Neonatal Medicine
- Mycology
- Infectious Diseases
Background:
- Premature neonates, especially those with low birth weight (<1,200 g), are susceptible to invasive fungal infections.
- Systemic candidiasis poses a significant risk in neonates receiving broad-spectrum antibiotics and parenteral nutrition.
Observation:
- Two premature neonates developed systemic candidiasis with clinical manifestations including necrotizing enterocolitis and renal abscesses.
- Candida albicans was identified in blood, urine, and stool cultures.
- Elevated levels of the Candida antigen, mannan, were detected in serum during clinical deterioration.
Findings:
- Systemic antifungal therapy was administered for six weeks.
- Prolonged antigenemia persisted despite negative follow-up cultures, indicating the utility of antigen monitoring.
- Antifungal treatment was discontinued once antigen levels normalized, leading to patient recovery.
Implications:
- Candida antigen detection (mannan) may serve as a valuable biomarker for diagnosing disseminated candidiasis in premature infants.
- Monitoring antigen levels can inform the duration and efficacy of antifungal treatment.
- This diagnostic approach can improve patient outcomes and reduce the risk of recurrent fungal infections in high-risk neonates.
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