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Early onset systemic Candida infection in extremely preterm neonates

C Melville1, S Kempley, J Graham

  • 1Paediatric Department, Royal London Hospital, Whitechapel, U.K.

European Journal of Pediatrics
|October 1, 1996
PubMed

Insights

Severe Candida infections in preterm neonates occur much earlier than previously thought, often within days of birth. This suggests the premature infant

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pediatric Critical Care

Background:

  • Systemic Candida infections typically present in neonates around one month of age.
  • Recent observations in a Regional Neonatal Intensive Care Unit (NICU) identified a pattern of early-onset severe Candida infections.

Purpose of the Study:

  • To characterize the clinical presentation and timing of severe Candida infections in extremely preterm neonates.
  • To investigate potential contributing factors to the early onset of these infections.

Main Methods:

  • Retrospective case series analysis over an 18-month period.
  • Inclusion criteria: neonates < 26 weeks gestation and < 0.75 kg birth weight with severe Candida infection.
  • Data collection focused on age at onset and clinical features.

Main Results:

  • Seven cases of severe Candida infection were identified in extremely preterm infants (< 26 weeks gestation, < 0.75 kg).
  • The median age of onset was significantly earlier at 7 days (range 0-17 days) compared to classical presentation.
  • Prominent clinical features included thrombocytopenia, coagulopathy, hypotension, edema, and skin breakdown.

Conclusions:

  • Extremely preterm infants, particularly those with a compromised cutaneous barrier, are susceptible to early-onset systemic Candida infections.
  • Characteristic skin manifestations may serve as an early diagnostic clue for invasive candidiasis in this vulnerable population.
Abstract

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