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Neonatal cerebral candidiasis: CT findings and clinical correlation
1Department of Radiology, Ondokuz Mayýs University, Medical School Samsun, Turkey.
Abstract:
Lumbar puncture in a premature newborn undergoing therapy for sepsis revealed meningitis. Contrast-enhanced cranial tomography revealed multiple, homogeneously or ring-like enhanced lesions with peripheral edema. Cerebrospinal fluid culture showed growth of candida. Significant clinical recovery after Amphotericin-B treatment was noted. Follow-up CT examination showed regression of the lesions. Five months later no pathology was reported except small calcified granulomas and an area of encephalomalacia.
Insights
A premature newborn with sepsis developed meningitis caused by candida. Treatment with Amphotericin-B led to clinical recovery and lesion regression, with residual calcified granulomas.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatric Neurology
Background:
- Sepsis is a serious condition in premature newborns.
- Meningitis can be a complication of sepsis in neonates.
- Fungal meningitis is a rare but severe infection in premature infants.
Observation:
- A premature newborn treated for sepsis was diagnosed with meningitis via lumbar puncture.
- Cranial tomography showed multiple enhanced lesions with edema.
- Cerebrospinal fluid culture identified Candida species.
Findings:
- The patient received Amphotericin-B treatment for fungal meningitis.
- Significant clinical improvement was observed post-treatment.
- Follow-up imaging demonstrated regression of intracranial lesions.
Implications:
- Early diagnosis and treatment of fungal meningitis are crucial in premature neonates.
- Amphotericin-B is an effective treatment for Candida meningitis.
- Long-term outcomes may include residual neurological changes such as calcified granulomas and encephalomalacia.