Journal Article

Candidal Meningitis in Neonates: A 10-Year Review

Marisol Fernandez, Edina H. Moylett, Daniel E. Noyola and Carol J. Baker

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 2, pages 458-463
Published in print August 2000 | ISSN: 1058-4838
Published online August 2000 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/313973
Candidal Meningitis in Neonates: A 10-Year Review

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Candidal meningitis may complicate systemic candidiasis in the premature neonate. We conducted a 10-year retrospective review of 106 cases of systemic candidiasis in neonates to define the incidence, clinical features, laboratory findings, treatment, and outcome of candidal meningitis. Twenty-three of the 106 neonates had candidal meningitis (0.4% of admissions to the neonatal intensive care unit). The median gestational age was 26.2 weeks, the median birth weight was 820 g, and the median age at the onset of illness was 8 days. Clinical disease was severe and commonly was manifested by respiratory decompensation. Findings of cerebrospinal fluid (CSF) analyses varied: pleocytosis was inconsistent, hypoglycorrhachia was common, gram staining was uniformly negative, and Candida was isolated from 17 neonates (74%). Each infant was treated with amphotericin B (median cumulative dose, 30 mg/kg); 5 also received flucytosine therapy. In conclusion, initial clinical features of candidal meningitis are indistinguishable from those of other causes of systemic infection in premature neonates, and normal CSF parameters do not exclude meningitis. Timely initiation of amphotericin B monotherapy was associated with an excellent outcome.

Journal Article.  4095 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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