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Urinary tract candidiasis in neonates and infants
R J Hitchcock1, A Pallett, M A Hall
1Department of Paediatric Urology, Southampton General Hospital, UK.
British Journal of Urology
|August 1, 1995
Summary
Invasive Candida infections in infants range from simple urinary tract infections to sepsis. Treatment with fluconazole and flucytosine is effective, questioning the role of surgery.
Area of Science:
- Neonatal and pediatric infectious diseases
- Mycology in clinical settings
- Urology and nephrology in infants
Background:
- Invasive Candida infections pose a significant threat to neonates and infants, presenting a spectrum of disease severity.
- Understanding the clinical manifestations and effective treatment strategies is crucial for improving outcomes in this vulnerable population.
Observation:
- A review of five infants with invasive urinary tract Candida infections revealed disease severity ranging from localized infection to multi-organ sepsis.
- Urinary tract obstruction was a predisposing factor in three cases, highlighting the importance of addressing anatomical abnormalities.
Findings:
- All infections were successfully cleared using a treatment protocol combining antifungal drugs and, in some cases, surgery.
- The study suggests that surgical intervention may be limited to relieving urinary obstruction, with antifungal therapy being the primary treatment modality.
- Resolution of renal pelvic fungal balls was achieved without surgery in two cases, indicating the efficacy of medical management.
Implications:
- The findings advocate for the use of oral fluconazole for early systemic Candida infections and a combination of fluconazole and flucytosine for severe cases, offering an alternative to toxic intravenous amphotericin.
- This approach may reduce the need for invasive surgical procedures, improving patient recovery and minimizing treatment-related complications.