Systemic Candida infection in extremely low birth weight infants: short term morbidity and long term neurodevelopmental outcome

Abstract

Systemic Candida infection is associated with increased short and long term morbidity in extremely low birth weight infants. Candida infection of the central nervous system has a significant impact on long term neurodevelopmental outcome. Performance of cranial ultrasound examination is recommended as a part of the diagnostic investigation in these infants. Detection of brain parenchymal involvement might provide further information to predict outcome.

Neonatal Candida meningitis: significance of cerebrospinal fluid parameters and blood cultures

“…Unremarkable CSF parameters in the presence of Candida CNS infection are consistent with the pathophysiology of disease, because candidiasis of the CNS develops as a meningoencephalitis with subcortical and cortical granulomas, parenchymal abscesses and vasculitis. 6,7 In a report by Faix et al, 8 only 50% (5/10) of the infants with culture-proven Candida meningitis had CSF WBC counts higher than 25 cells/mm 3 . A similar percentage of infants with elevated CSF WBC count (52%, 9/17) was observed in another cohort of infants with definite Candida meningitis, 9 and an even lower percentage (20%, 2/10) was found in another series.…”

Systemic fungal infection is associated with the development of retinopathy of prematurity in very low birth weight infants: a meta-review

“…Finally, seven studies plus an abstract, all retrospective cohort studies, were found by both the authors and were included for analysis in this review. [12][13][14][15][16][17][18]20 The characteristics of these studies are presented in Table 1. There were many similarities and differences in the studies.…”

“…There were also differences among studies. All patients included were only ELBW in some studies 12,[15][16][17][18]20 but VLBW and ELBW in others. 13,14 Also, all studies expressed their central tendency and measures of dispersion as mean ± standard deviation except one which expressed it as median and range.…”

“…The outcomes studied were ROP and threshold ROP in all except one that studied in addition to ROP, other short-term morbidity and long-term neurodevelopmental outcomes. 20 Classification of SFI was done differently by different studies. Some studies 12,14,16 -18 defined candida sepsis as positive blood culture for candida.…”

“…The cases and control groups in each of the studies were closely matched and the internal validity of the data was present in half of the studies and was either absent 12 or not available in others. 16,17,20 Raw data of two studies 12,16 from the same institution were combined to avoid duplication as their study periods overlapped and had a total of 185 patients including 133 patients from the study by Mittal et al 12 …”