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Neonatal Candidemia Caused by Candida haemulonii: Case Report and Review of Literature

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Abstract

Candidemia is a frequent condition in Neonatal Intensive Care Units (NICU) and usually complicates the newborns clinical course. Several factors are responsible for candidiasis, such as prematurity and use of broad-spectrum antibiotics, and in these cases, there are the involvement of various Candida species, as C. albicans, and C. parapsilosis. However, other species as C. haemulonii has been rarely described in candidemia cases, being considered an emergent pathogen. Thus, we report a case of neonatal candidemia by C. haemulonii and a review of literature of fungemia by this yeast. The patient was a neonate with gestational age of 26 weeks and birth weight of 660 g hospitalized in a NICU from a Brazilian hospital. The identification of the etiological agent was performed by phenotypic methods, scanning electron microscopy, sequencing of the ITS region of rDNA, and mass spectrometry. Antifungal susceptibility testing was carried out according to the Clinical Laboratories and Standards Institute guidelines. The newborn was diagnosed with candidemia by C. haemulonii resistant to amphotericin B with minimal inhibitory concentration (MIC) of 8 µg/mL, sensitive to fluconazole (MIC: 8 µg/mL) and voriconazole (MIC: 0.12 µg/mL). The treatment with fluconazole (12 mg/kg/day) was established with good outcome. Candidemia by C. haemulonii is still being limited to a few sporadic cases in adults with endemic and restricted occurrences in neonates. Usually, the therapy with amphotericin B is ineffective against this species. Our results showed the importance of the mycological diagnosis associated to antifungigrama for the successful clinical management followed by important epidemiological data.

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Acknowledgments

We thank the Coordination of Improvement of Higher Education Personnel (CAPES) for funding. We acknowledge the Special Mycology Laboratory—EPM/UNIFESP, Brazil, for DNA sequencing and CETENE for scanning electronic microscopy analysis.

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Authors and Affiliations

  1. Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, PE, 50670-901, Brazil

    Carolina M. Silva, Ana M. R. Carvalho-Parahym, Danielle P. C. Macêdo, Reginaldo G. Lima-Neto, Rosemary M. J. Amorim & Rejane P. Neves

  2. Federal University of São Paulo, São Paulo, Brazil

    Elaine C. Francisco & Analy S. A. Melo

  3. Memorial Guararapes Hospital, Jaboatão dos Guararapes, Brazil

    Maria da Conceição M. Silva & Moacir B. Jucá

  4. Real Portuguese Hospital, Recife, Brazil

    Luciana R. B. Mello

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  1. Carolina M. Silva
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  2. Ana M. R. Carvalho-Parahym
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  3. Danielle P. C. Macêdo
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  4. Reginaldo G. Lima-Neto
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  5. Elaine C. Francisco
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  6. Analy S. A. Melo
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  7. Maria da Conceição M. Silva
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  8. Moacir B. Jucá
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  10. Rosemary M. J. Amorim
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  11. Rejane P. Neves
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Correspondence to Rejane P. Neves.

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Silva, C.M., Carvalho-Parahym, A.M.R., Macêdo, D.P.C. et al. Neonatal Candidemia Caused by Candida haemulonii: Case Report and Review of Literature. Mycopathologia 180, 69–73 (2015). https://doi.org/10.1007/s11046-015-9872-7

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  • DOI: https://doi.org/10.1007/s11046-015-9872-7

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