Abstract
This manuscript reports on two very low birth weight premature infants with respiratory distress, receiving parenteral nutrition and broad-spectrum antibiotics for about 3 weeks, who developed Candida albicans sepsis associated with fungal mycoses and endocarditis, despite treatment with Amphotericin B and Caspofungin. On days 40 and 47, respectively, antifungal therapy was modified to liposomal Amphotericin B combined with Fluconazole 6 mg/kg/day for 4 weeks, resulting in complete resolution of the mycetomas. Our observations suggest that the combination of liposomal Amphotericin B with Fluconazole is able to result in complete resolution of cardiac mycetomas in preterm infants.
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Ariffin H, Ariffin W, Tharam S, Omar A, de Bruyne J, Lin HP (1999) Successful treatment of Candida albicans endocarditis in a child with leukemia—a case report and review of the literature. Singapore Med J 40:533–536
Bendel CM (2005) Nosocomial neonatal candidiasis. Pediatr Infect Dis J 24:831–832
Benjamin DK Jr, Poole C, Steinbach WJ, Rowen JL, Walsh TJ (2003) Neonatal candidemia and end-organ damage: a critical appraisal of the literature using meta-analytic techniques. Pediatrics 112:634–640
Benjamin DK Jr, Stoll BJ, Fanaroff AA, McDonald SA, Oh W, Higgins RD, Duara S, Poole K, Laptook A, Goldberg R; on behalf of the National Institute of Child Health and Human Development Neonatal Research Network (2006) Neonatal candidiasis among extremely low birth weight infants: risk factors, mortality rates, and neurodevelopmental outcomes at 18 to 22 months. Pediatrics 117:84–92
Levy I, Shalit I, Birk E, Sirota L, Ashkenazi S, German B (2006) Candida endocarditis in neonates: report of five cases and review of the literature. Mycoses 49:43–48
Manzoni P, Stolfi I, Pugni L, Decembrino L, Magnani C, Vetrano G, Tridapalli E, Corona G, Giovannozzi C, Farina D, Arisio R, Merletti F, Maule M, Mosca F, Pedicino R, Stronati M, Mostert M, Gomirato G; for the Italian Task Force for the Study and Prevention of Neonatal Fungal Infection and the Italian Society of Neonatology (2007) A multicenter, randomized trial of prophylactic fluconazole in preterm neonates. N Engl J Med 356:2483–2493
Millar BC, Jugo J, Moore JE (2005) Fungal endocarditis in neonates and children. Pediatr Cardiol 26:517–536
Noyola DE, Fernandez M, Moylett EH, Baker CJ (2001) Ophthalmologic, visceral, and cardiac involvement in neonates with candidemia. Clin Infect Dis 32:1018–1023
Odio CM, Araya R, Pinto LE, Castro CE, Vasquez S, Alfaro B, Sàenz A, Herrera ML, Walsh TJ (2004) Caspofungin therapy of neonates with invasive candidiasis. Pediatr Infect Dis J 23:1093–1097
Pappas PG, Rex JH, Sobel JD, Filler SG, Dismukes WE, Walsh TJ, Edwards JE; Infectious Diseases Society of America (2004) Guidelines for treatment of candidiasis. Clin Infect Dis 38:161–189
Procianoy RS, Enéas MV, Silveira RC (2006) Empiric guidelines for treatment of Candida infection in high-risk neonates. Eur J Pediatr 165:422–423
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Karatza, A.A., Dimitriou, G., Marangos, M. et al. Successful resolution of cardiac mycetomas by combined liposomal Amphotericin B with Fluconazole treatment in premature neonates. Eur J Pediatr 167, 1021–1023 (2008). https://doi.org/10.1007/s00431-007-0634-5
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DOI: https://doi.org/10.1007/s00431-007-0634-5