“White dots on the placenta and red dots on the baby”: congential cutaneous candidiasis—a rare disease of the neonate

Abstract

Cutaneous congenital candidiasis (CCC) is a very rare disease of the term or premature infant consisting of a generalized rash at or shortly after birth usually without other signs or symptoms. The presence of white microabscesses on the placenta and umbilical cord of an infant with such a rash must suggest the diagnosis of CCC, which is always secondary to Candida chorioamnionitis but may pass unrecognized. Despite the high prevalence of vulvo-vaginitis in pregnant women, Candida chorioamnionitis is rare and CCC remains apparently extremely rare with just some hundred cases described. However, as the condition is essentially benign and self-limited, underdiagnosis is likely. As occasional systemic spread of Candida infection is described and maternal complications may arise, diagnosis and a close follow-up or treatment is of importance. We present two cases of CCC, stressing the importance of sharing clinical findings between obstetrician and neonatologist for the diagnosis and subsequent management.

Congenital candidiasis presenting as septic shock without rash

“…The presentation with overwhelming clinical sepsis and neutropenia appeared most consistent with bacterial sepsis. There was no evidence of “white dots on the placenta and red dots on the baby”, as is classically described with congenital candidiasis 2 – 4. The postmortem examination found no rash or skin lesions on twin 1, and no typical macroscopic lesions on the placenta.…”

Congenital candidiasis presenting as septic shock without rash

“…There was no evidence of ''white dots on the placenta and red dots on the baby'', as is classically described with congenital candidiasis. [2][3][4] The post-mortem examination found no rash or skin lesions on twin I, and no typical macroscopic lesions on the placenta.…”

Congenital cutaneous candidiasis and candidemia in a preterm infant: A case report

“…[2] Ascending infection may occur either with rupture of membranes or through intact membranes resulting in whitish plaques on membranes and umbilical cord along with skin lesions. [6] Due to immaturity of the immune system and of the mucocutaneous barrier, ELBW infants are at substantially higher risk for systemic involvement than term infants. Some authors propose to consider CCC in preterm infants as an invasive Candida infection and to start systemic treatment as soon as diagnosis is suspected.…”