Document Detail


Systemic candidiasis in very low-birth-weight infants (less than 1,500 grams).
MedLine Citation:
PMID:  6694869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous reports in the literature have documented that systemic infection with Candida albicans in very premature infants is frequently fatal (54%) or associated with significant morbidity in survivors (25%). Five patients with a mean birth weight of 829 g had a diagnosis of systemic candidiasis during their stay in a newborn intensive care unit. All infants survived with minimal sequelae following aggressive early treatment with amphotericin B and 5-flucytosine. A review of these five extremely premature infants and 26 previously reported patients suggests the following: (1) disseminated candidiasis is common in the absence of positive findings in blood, CSF, and/or urine cultures; (2) transient candidemia rarely resolves without therapy; (3) meningitis and osteoarthritis occur more frequently than in older patients with disseminated disease; and (4) premature infants tolerate amphotericin B and 5-flucytosine well. Infants who are found to have systemic cultures positive for candidiasis should be treated by (1) removing all factors that predispose to systemic candidiasis (eg, indwelling catheters, broad-spectrum antibiotics); (2) early initiation of systemic antifungal therapy with amphotericin B and 5-flucytosine; and (3) searching for additional foci of disease. After the disease is recognized and treatment is prompt and aggressive, outcome can be substantially improved.
Authors:
D E Johnson; T R Thompson; T P Green; P Ferrieri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  73     ISSN:  0031-4005     ISO Abbreviation:  Pediatrics     Publication Date:  1984 Feb 
Date Detail:
Created Date:  1984-03-07     Completed Date:  1984-03-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  138-43     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Amphotericin B / therapeutic use*
Candidiasis / diagnosis,  drug therapy*
Cytosine / analogs & derivatives*
Female
Flucytosine / therapeutic use*
Humans
Infant
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature, Diseases / diagnosis,  drug therapy*
Chemical
Reg. No./Substance:
1397-89-3/Amphotericin B; 2022-85-7/Flucytosine; 71-30-7/Cytosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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