Title: Postmortem Disseminated Candidemia: A Case Report from a Tertiary Care Center

Authors: Dr Sinduja Raghuraman, Dr Mary Mathew

 DOI: https://dx.doi.org/10.18535/jmscr/v11i6.14

Abstract

Candidiasis is a fungal infection most commonly caused by Candida albicans in very low birth weight neonates. The various presentations are disseminated candidiasis, fungal endocarditis and mucocutaneous involvement. A 26 week old extreme preterm female neonate presented with severe respiratory distress and abdominal distension and diagnosed as Necrotizing enterocolitis. Pericardial biopsy showed PAS positive hyphae colonies and budding yeast forms. Blood culture though not a sensitive indicator is reliable in undiscovered candidemia in the ante mortem period and reflected by pericardial biopsy in the post mortem period.

Keywords: Candida, disseminate, fungemia, post mortem, sepsis.

References

  1. Ahmed MME-S, Kurkluoglu M, Hynes CF, Klugman D, Puscasiu E, Nath DS. Intracardiac Fungal Mass in a Term Neonate. Methodist DeBakey cardiovascular journal. 2016;12(4):225.
  2. Potasman I, Leibovitz Z, Sharf M. Candida sepsis in pregnancy and the postpartum period. Reviews of infectious diseases. 1991;13(1):146-9.
  3. Thorn JL, Gilchrist KB, Sobonya RE, Gaur NK, Lipke PN, Klotz SA. Postmortem candidaemia: marker of disseminated disease. Journal of clinical pathology. 2010;63(4):337-40.
  4. Rode ME, Morgan MA, Ruchelli E, Forouzan I. Clinical Perinatal/Neonatal Case Presentations-Candida Chorioammionitis After Serial Therapeutic Amniocenteses: A Possible Association. Journal of Perinatology. 2000;20(5):335-7.
  5. Mogyorósy G, Soós G, Nagy A. Candida endocarditis in a premature infant. Walter de Gruyter; 2000.
  6. Azhar A. Successful management of fungal pericarditis and endocarditis in a neonate: A case report. Journal of the Saudi Heart Association. 2012;24(3): 195-9.
  7. Mandai S, Banerjee M, Mallick AK. Congenital Candidiasis in a Newborn. Journal of the Pediatrics Association of India. 2018;7(2):120.
  8. Kaufman DA. Challenging issues in neonatal candidiasis. Current medical research and opinion. 2010;26(7):1769-78.
  9. Manzoni P, Mostert M, Galletto P, Gastaldo L, Gallo E, Agriesti G, et al. Is thrombocytopenia suggestive of organism‐specific response in neonatal sepsis? Pediatrics International. 2009;51 (2):206-10.
  10. Benjamin DK, DeLong ER, Steinbach WJ, Cotton CM, Walsh TJ, Clark RH. Empirical therapy for neonatal candidemia in very low birth weight infants. Pediatrics. 2003;112(3):543-7.
  11. Whyte R, Hussain Z, DeSa D. Antenatal infections with Candida species. Archives of Disease in Childhood. 1982;57(7):528-35.

Corresponding Author

Dr. Sinduja Raghuraman

Assistant Professor, Department of Pathology, Trichy SRM Medical College Hospital and Research Center, Trichy