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Neonatal Torulopsis glabrata fungemia
J D Reich1, K Huddleston, D Jorgensen
1Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga. 30303, USA.
Southern Medical Journal
|February 1, 1997
Summary
Torulopsis glabrata fungemia is a rare but serious opportunistic infection in premature infants. Early treatment with amphotericin B and reducing risk factors can improve outcomes.
Area of Science:
- Mycology
- Neonatal Medicine
- Infectious Diseases
Background:
- Torulopsis glabrata is an opportunistic fungal pathogen.
- Infections in neonates are rare, with only four reported cases prior to this study.
Observation:
- Two cases of fungemia caused by Torulopsis glabrata in premature infants are presented.
- Both infants had received surfactant, artificial ventilation, intravascular catheters, broad-spectrum antibiotics, and hyperalimentation.
- One infant survived the fungal infection but later died of bacterial sepsis.
Findings:
- Torulopsis glabrata fungemia is associated with significant iatrogenic risk factors in premature infants.
- The organism is susceptible to amphotericin B and 5-fluorocytosine.
- Resistance to fluconazole and reduced susceptibility to other azoles (ketoconazole, clotrimazole, itraconazole) were noted compared to Candida albicans.
Implications:
- Reducing iatrogenic risk factors is crucial for preventing Torulopsis glabrata fungemia.
- Initial treatment should involve amphotericin B, with 5-fluorocytosine as a potential addition.
- Further research into the pathogenesis and optimal management of Torulopsis glabrata infections in neonates is warranted.