Candidiasis caused by Candida kefyr in a neonate: Case report

BMC Infectious Diseases

Case Report

Anna Kristina Kilian¹  Katrin Zahn²  Konrad Reinshagen²  Annebärbel Dietz³  Gernot Geginat³  Tobias Tenenbaum⁴  Horst Schroten⁴  Stefan Weichert⁵ 

[1] Department of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim of Heidelberg University, Mannheim, Germany;Department of Pediatric Surgery, University Hospital Mannheim of Heidelberg University, Mannheim, Germany;Institute for Medical Microbiology and Hygiene, University Hospital Mannheim of Heidelberg University, Mannheim, Germany;Pediatric Infectious Diseases, University Children's Hospital Mannheim of Heidelberg University, Mannheim, Germany;Pediatric Infectious Diseases, University Children's Hospital Mannheim of Heidelberg University, Mannheim, Germany;Pediatric Infectious Diseases, University Children's Hospital Mannheim of Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany;

关键词: Children;    Candidiasis;    albicans Candida;    Urinary tract infection;   

DOI  :  10.1186/1471-2334-12-61

 received in 2011-09-04, accepted in 2012-03-18,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundSystemic Candidia infections are of major concern in neonates, especially in those with risk factors such as longer use of broad spectrum antibiotics. Recent studies showed that also term babies with underlying gastrointestinal or urinary tract abnormalities are much more prone to systemic Candida infection. We report a very rare case of candidiasis caused by Candida kefyr in a term neonate.Case PresentationRenal agenesis on the left side was diagnosed antenatally and anal atresia postnatally. Moreover, a vesico-ureteral-reflux (VUR) grade V was detected by cystography. The first surgical procedure, creating a protective colostoma, was uneventful. Afterwards our patient developed urosepsis caused by Enterococcus faecalis and was treated with piperacillin. The child improved initially, but deteriorated again. A further urine analysis revealed Candida kefyr in a significant number. As antibiotic resistance data about this non-albicans Candida species are limited, we started liposomal amphotericin B (AMB), but later changed to fluconazole after receiving the antibiogram. Candiduria persisted and abdominal imaging showed a Candida pyelonephritis. Since high grade reflux was prevalent we instilled AMB into the child's bladder as a therapeutic approach. While undergoing surgery (creating a neo-rectum) a recto-vesical fistula could be shown and subsequently was resected. The child recovered completely under systemic fluconazole therapy over 3 months.ConclusionsCandidiasis is still of major concern in neonates with accompanying risk factors. As clinicians are confronted with an increasing number of non-albicans Candida species, knowledge about these pathogens and their sensitivities is of major importance.

【 授权许可】

CC BY   
© Weichert et al; licensee BioMed Central Ltd. 2012