Congenital systemic candidiasis: a comprehensive literature review and meta-analysis of 44 cases

Abstract

Systemic candidiasis is a frequent complication in neonatal units, but congenital systemic candidiasis is an unusual diagnosis, observed in both full-term and preterm infants, with less than 50 cases reported to date. Congenital candidiasis presents with a wide spectrum of symptoms, ranging from diffuse skin eruptions to severe systemic disease, resulting in fetal demise or early neonatal death. Although management guidelines have been published almost two decades ago, due to the rarity of this type of infection, conclusive recommendations are difficult to establish, since they are based on anecdotal experience. In this paper, we present a comprehensive meta-analysis of the current scientific knowledge regarding congenital candidiasis, which spans 54 years and includes a total of 44 cases.

Congenital Cutaneous Candidiasis in a Premature Neonate. Case Report

“…In addition, further risk factors are the presence of intrauterine devices, maternal history of cervical cerclage, and invasive maneuvers during delivery 5 . Less common risk factors that may participate CCC are the time of membrane rupture and the mother's diagnosis of fungal vaginosis previously [4][5][6] . Furthermore, this condition may occur either from vaginal or abdominal delivery [4][5][6] .…”

“…Less common risk factors that may participate CCC are the time of membrane rupture and the mother's diagnosis of fungal vaginosis previously [4][5][6] . Furthermore, this condition may occur either from vaginal or abdominal delivery [4][5][6] . Regarding mucocutaneous compromise, manifestations are the result of the aspiration of infected amniotic fluid 6 .…”

“…Clinically, CCC develops within the first week of life, usually within a few hours of birth. It has a heterogeneous presentation that varies according to the following factors: host immune response, number of microorganisms, and time of exposure [1][2][3][4][5][6] . It typically initiates with diffuse maculopapular exanthema, with scaly patches localized in the face, scalp, extensor surfaces of extremities, and umbilical region 2 .…”

“…Management includes non-azole antifungal Amphotericin B, 1mg/kg for Amphotericin B deoxycholate, and 5 mg/kg for lipid-associated Amphotericin B preparations. [3][4][5][6][7][8][9] . In addition, 6-12 mg/kg fluconazole is also recommended 10 .…”

Congenital cutaneous candidiasis in a premature neonate: A case report

“…CCC is estimated to occur in 0.1% of NICU admissions. 1 , 2 , 3 Common risk factors include preterm neonates, gestational age less than 27 weeks, and weight <1000 g. 4 In addition, further risk factors are the presence of intrauterine devices, maternal history of cervical cerclage, and invasive maneuvers during delivery. 5 Other risk factors that may participate CCC are premature membrane rupture and the mother's diagnosis of fungal vaginosis previously.…”