Central nervous system candidiasis in the high-risk neonate

被引:24
作者
Faix, RG
Chapman, RL
机构
[1] Univ Utah, Sch Med, Div Neonatol, Salt Lake City, UT 84132 USA
[2] Yale Univ, Sch Med, Dept Pediat, Div Neonatal Perinatal Med, New Haven, CT 06510 USA
关键词
D O I
10.1016/S0146-0005(03)00065-X
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Central nervous system involvement in neonatal candidiasis is not rare, although possibly less frequent than in previous decades. In addition to increasing the potential for neurodevelopmental morbidity, this infection poses major challenges in establishing diagnosis and assuring adequate treatment. In the setting of candidemia or other severe invasive candida disease, suggestive imaging studies or inflammatory changes in cerebrospinal fluid should prompt careful consideration of central nervous system candidiasis even if culture of the fluid is negative. Although delivery of amphotericin to cerebrospinal fluid appears much better in premature infants than in older individuals, the availability of other agents with superior delivery to the central nervous system suggests that strong consideration be given to their use as alternative or adjunct therapy if central nervous system involvement appears likely. Careful surveillance for neurodevelopmental sequelae may permit early detection, timely rehabilitative intervention, and potentially better long-term functional outcomes. © 2003 Elsevier Inc. All rights reserved.
引用
收藏
页码:384 / 392
页数:9
相关论文
共 62 条
[1]   Liposomal amphotericin B in neonates with invasive candidiasis [J].
AlArishi, H ;
Frayha, HH ;
Kalloghlian, A ;
AlAlaiyan, S .
AMERICAN JOURNAL OF PERINATOLOGY, 1997, 14 (09) :573-576
[2]  
AVERBACK P, 1978, CHILD BRAIN, V4, P33
[3]   PHARMACOKINETICS, OUTCOME OF TREATMENT, AND TOXIC EFFECTS OF AMPHOTERICIN-B AND 5-FLUOROCYTOSINE IN NEONATES [J].
BALEY, JE ;
MEYERS, C ;
KLIEGMAN, RM ;
JACOBS, MR ;
BLUMER, JL .
JOURNAL OF PEDIATRICS, 1990, 116 (05) :791-797
[4]   When to suspect fungal infection in neonates:: A clinical comparison of Candida albicans and Candida parapsilosis fungemia with coagulase-negative staphylococcal bacteremia [J].
Benjamin, DK ;
Ross, K ;
McKinney, RE ;
Benjamin, DK ;
Auten, R ;
Fisher, RG .
PEDIATRICS, 2000, 106 (04) :712-718
[5]   REAL-TIME ULTRASONOGRAPHIC SURVEILLANCE IN THE DETECTION OF CNS INVOLVEMENT IN SYSTEMIC CANDIDA INFECTION [J].
BOZYNSKI, ME ;
NAGLIE, RA ;
RUSSELL, EJ .
PEDIATRIC RADIOLOGY, 1986, 16 (03) :235-237
[6]   OSTEOMYELITIS IN A NEONATAL INTENSIVE-CARE UNIT [J].
BRILL, PW ;
WINCHESTER, P ;
KRAUSS, AN ;
SYMCHYCH, P .
RADIOLOGY, 1979, 131 (01) :83-87
[7]   AMPHOTERICIN-B AS A SINGLE AGENT IN THE TREATMENT OF SYSTEMIC CANDIDIASIS IN NEONATES [J].
BUTLER, KM ;
RENCH, MA ;
BAKER, CJ .
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 1990, 9 (01) :51-56
[8]   Persistently positive cultures and outcome in invasive neonatal candidiasis [J].
Chapman, RL ;
Faix, RG .
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2000, 19 (09) :822-827
[9]  
Chen Jia-Yuh, 1994, Acta Paediatrica Japonica, V36, P261
[10]  
CHESNEY PJ, 1978, JOHNS HOPKINS MED J, V142, P155