S. Tadros1, H. Ntouganioti1, A. Mitroussia2, M. Kimouli1, A. Bakossi1, M. Theodoraki1, D. Petropoulou1, A. Tsakris2

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1General Hospital of Nikea, NIKEA, Greece 2Medical School, University of Athens, ATHENS, Greece


Introduction: Candida congenital meningitis in neonates is very rare. Case: A set of female dizygotic twins, were born 32wks of gestation. Twin 913; died within few hours, while twin ' was transfered to our NICU. Their mother was treated for cervical incompetence and vaginal candidiasis during the 2nd trimester of her pregnancy. Baby ' was started on empiric antibiotic therapy, because of elevated CRP, and very low CSF glucose level. Blood and CSF cultures were negative. On day 8, the neonate looked slightly unwell, LP was repeated. CSF glucose remained very low, protein level was high with pleiocytosis (478 cells/mm3, and lymphocyte predominance), indicating chronic meningitis. Blood and urine cultures were sterile. PCR for bacterial genomes, HSV, CMV, enteroviruses, ureaplasma, and Candida albicans were negative. Stool cultures grew Candida albicans. U/S and MRI brain showed mild signs of ventriculitis, while ophthalmologic and cardiologic screenings were normal. Wide spectrum antibiotics were initiated. On day 40 (4th week of antibiotic), LP showed the same findings as above, but this time CSF culture was positive for Candida albicans. Antifungal therapy was given for four weeks. At the end of therapy, LP and brain MRI findings were normal. The baby remained clinically well throughout therapy. Comments: Congenital candidiasis, and especially meningitis is very uncommon. 913;s in our case, the low pathogen load has been previously described to cause false negative results at the beginning of Candida congenital infections. The diagnosis of Candida congenital meningitis was made on bases of mother’s obstetric history and response of persistent CSF abnormal findings from birth to anti- fungal treatment, as well as clinical and microbiological response to antifungal treatment.

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Full conference title: 

4th Trends in Medical Mycology
    • TIMM 4th (2012)