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Unrecognized Candida brain abscess in infancy: two cases and a review of the literature
Abstract:
Two infants with presumed Candida species brain abscesses are presented. Six other infants with the same problem were found in a search of the literature, and some of the clinical and pathologic features of these patients are presented and discussed. All diagnoses were made post-mortem. There was frequent association with gastrointestinal pathology and subsequent surgery, and with antibiotic administration. Central nervous system signs and symptoms were not a prominent feature, and although most patients had disseminated candidiasis, one patient had an isolated macroscopic cerebral abscess.
Insights
Candida species brain abscesses in infants are rare, often diagnosed post-mortem. These cases frequently link to gastrointestinal issues, surgery, and antibiotics, with subtle neurological signs.
Area of Science:
- Medical Mycology
- Pediatric Pathology
- Infectious Diseases
Background:
- Candida species are common opportunistic pathogens.
- Brain abscesses in neonates and infants are uncommon but serious infections.
- Disseminated candidiasis can affect multiple organs, including the central nervous system.
Observation:
- Presents two infants with presumed Candida species brain abscesses.
- Reviews six additional cases from literature, totaling eight patients.
- All diagnoses were confirmed post-mortem.
Findings:
- Frequent association with gastrointestinal pathology and prior surgery.
- Commonly linked to antibiotic administration.
- Central nervous system signs were not prominent.
- Most patients had disseminated candidiasis, but one had an isolated cerebral abscess.
Implications:
- Highlights the need for increased awareness of Candida brain abscesses in at-risk infant populations.
- Suggests potential diagnostic challenges due to non-specific clinical presentation.
- Underscores the importance of considering fungal infections in neonatal and infant sepsis, especially with gastrointestinal complications or antibiotic exposure.