Candida glabrata Sepsis Associated With Chorioamnionitis in an In Vitro Fertilization Pregnancy: Case Report and Review

Jackel, Damien; Lai, Katy

doi:10.1093/cid/cis936

Cited by 25 publications

(30 citation statements)

References 21 publications

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“…However, it actually has reduced virulence and migration ability across intact chorionic membranes as compared to Candida albicans . This may explain why the majority of the only 20 reported cases of C. glabrata chorioamnionitis in the literature [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19] involved some form of instrumentation and were associated with IVF [5,6,7,8,9,10,16,17,18,19] or presence of an intrauterine device [11,12,20,21]. …”

Section: Resultsmentioning

confidence: 99%

Candida glabrata Chorioamnionitis following in vitro Fertilization: Review of the Literature

Herman

Zussman

Haratz

et al. 2015

Gynecol Obstet Invest

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Aim: To review all past reports of Candida glabrata chorioamnionitis in the literature while noting their correlation with in vitro fertilization (IVF). Methods: We checked MEDLINE, PubMed and Google scholar (January 1970 to December 2014) for articles using the search terms ‘Candida', ‘Torulopsis', ‘glabrata', ‘chorioamnionitis', ‘congenital', ‘perinatal' and ‘infection'. Case reports were included if they described a verified intrauterine infection with C. glabrata. The authors reviewed the articles and abstracted the data. 20 cases were compared, including a case reported from our institution shortly described in this article. Results: 13 of 20 cases (65%) involved pregnancies achieved by IVF; 3 patients underwent amniocentesis during their pregnancy. Of the 7 cases with no history of IVF, 2 involved a history of cerclage and 2 a history of intrauterine device use. Only 6 infants survived, delivered prematurely by cesarean section. Conclusions: Review of literature demonstrated a high prevalence of IVF-assisted pregnancies among the few C. glabrata chorioamnionitis cases previously described, typically occurring during the second trimester. Additional cases were notable for additional instrumentation/invasive procedure. The prognosis was mostly grim, entailing a high incidence of stillbirth or rapid neonatal death.

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Section: Resultsmentioning

confidence: 99%

Candida glabrata Chorioamnionitis following in vitro Fertilization: Review of the Literature

Herman

Zussman

Haratz

et al. 2015

Gynecol Obstet Invest

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“…glabrata infection has also been reported as a cause of chorioamnionitis in healthy pregnant women [6][7][8]. The majority of cases appear to be reported in the IVF population and present at 15-24 weeks gestation.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of cases appear to be reported in the IVF population and present at 15-24 weeks gestation. The authors propose that the possible source of infection is the lower genital tract, with introduction of organisms into the uterus at time of embryo transfer [6][7][8]. In the non-IVF population, C. glabrata chorioamnionitis has been associated with foreign bodies (cerclage and intrauterine devices) and immunosuppression (untreated gestational diabetes) [6].…”

Section: Discussionmentioning

confidence: 99%

“…The authors propose that the possible source of infection is the lower genital tract, with introduction of organisms into the uterus at time of embryo transfer [6][7][8]. In the non-IVF population, C. glabrata chorioamnionitis has been associated with foreign bodies (cerclage and intrauterine devices) and immunosuppression (untreated gestational diabetes) [6]. Pregnancy is also a state of relative immunosuppression where there is suppression of pro-inflammatory cellular responses and activation of antiinflammatory responses, which encourages embryonic implantation [9,10].…”

Section: Discussionmentioning

confidence: 99%

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Candida glabrata Sepsis in an Immunocompetent Individual: A Case Report

Tan¹,

Reddy²,

Gupta³

et al. 2017

Gynecol Obstet Case Rep

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Candidaemia accounts for a significant proportion of systemic fungal infections, with Candida glabrata (C. glabrata) becoming prominent in recent decades. We describe a unique case where postoperative urinary retention and C. glabrata UTI led to invasive fungaemia with bladder necrosis. A 37-year-old previously well nulliparous woman underwent an elective diagnostic laparoscopy, hysteroscopy dilation and curettage, and dye studies for investigation of infertility. She re-presented six days post procedure with C. glabrata urosepsis with a subsequent laparoscopy on day 16 revealing fungal plaques in the bladder, and a large necrotic defect in the bladder dome. The patient was managed with bilateral nephrostomies, a pelvic drain and antifungal therapy. Four weeks post-insertion of the nephrostomies, a cystogram revealed spontaneous closure of bladder defect. The nephrostomies were removed and antibiotics and antifungals continued for a month until negative urine cultures were attained. The patient was well four months after discharge with mild urinary symptoms. The literature has reported two cases of candida UTIs resulting in bezoars and bladder rupture, occurring only in immunocompromised patients. This case highlights the challenges of C. glabrata sepsis and its potential for severe morbidity in a non-immunocompromised patient, suggesting the need for guidelines in the early detection and treatment of C. glabrata sepsis.

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“…C glabrata 's lack of pseudohypha formation results in decreased tissue adherence and difficulty in invading intact membranes9; hence many of its associated risk factors are those which permit direct introduction of the fungus into the endometrial cavity. Predisposing risk factors include antibiotic therapy, immunosuppression, underlying medical conditions, such as diabetes mellitus, coexisting intrauterine device, IVF-embryo transfer (ET), cervical stitch, rupture of membranes, and amniocentesis or chorionic villous sampling 3 4 13. A review of 16 cases of C glabrata chorioamnionitis in 2012 revealed that 63% of the cases were associated with IVF, and 81% with some form of instrumentation 3.…”

Section: Discussionmentioning

confidence: 99%

Severe systemic candidiasis following immunomodulation therapy in in vitro fertilisation-embryo transfer (IVF-ET)

et al. 2014

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A 41-year-old nulliparous woman, with a medical history of unexplained infertility and multiple in vitro fertilisation (IVF) cycles with immunosuppressive therapy, was admitted to our tertiary obstetrics unit with sepsis at 18 weeks of pregnancy with dichorionic diamniotic twins.Candida glabratawas grown from her blood cultures, then subsequently from the liquor and placentae. She was treated with intravenous ambisome (amphotericin), but unfortunately, the infection resulted in the rupture of her membranes, preterm labour and the demise of her twins. She delivered both twins at 23 weeks, 3 days apart. The antifungal agent was changed to high-dose fluconazole after delivery for 2 weeks and she is now well. Women undergoing IVF-embryo transfer with immunomodulation therapy have a potential risk of developing candidal chorioamnionitis and sepsis.

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Candida glabrata Sepsis Associated With Chorioamnionitis in an In Vitro Fertilization Pregnancy: Case Report and Review

Cited by 25 publications

References 21 publications

<b><i>Candida glabrata</i></b> Chorioamnionitis following in vitro Fertilization: Review of the Literature

<b><i>Candida glabrata</i></b> Chorioamnionitis following in vitro Fertilization: Review of the Literature

Candida glabrata Sepsis in an Immunocompetent Individual: A Case Report

Severe systemic candidiasis following immunomodulation therapy in in vitro fertilisation-embryo transfer (IVF-ET)

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