Drug resistant tachycardia and fever in a neonate: a case of systemic candidiasis
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Date
2016
Authors
Gunethilake, K.M.T.B.
Parthipan, S.
Vidanapathirana, M.
Beneragama, D.H.
Journal Title
Journal ISSN
Volume Title
Publisher
University of Peradeniya, Sri Lanka
Abstract
Introduction
Invasive fungal infection is a known cause of morbidity and mortality in the neonates especially in immunocompromised children. Demonstration of organisms by culture remains the gold standard for mycological diagnosis.
Case report
A neonate delivered at 34 weeks of gestation with a birth weight of 1800g was admitted to a premature baby unit with breathing difficulty on day 05 after delivery. On examination, the child was febrile and had tachyarrhythmia. Blood culture showed a mixed growth of organisms and the echocardiogram was suggestive of a cardiac tumor. The condition of the neonate deteriorated in spite of treatment with antibiotics and supportive therapy and the child died 20 days after admission. At autopsy, a large vegetation was found on the tricuspid valve.
Conclusion
Fungal endocarditis should have been considered as a possible cause especially in the presence of large vegetations in the right side of the heart in neonates. The presence of fungal abscesses in the kidneys supported the systemic nature of the infection. Tachyarrhythmias may have been due to the involvement of the conduction system of the heart as vegetations were found in the area of AV node.
Description
Keywords
Candida albicans , Systemic candidiasis , Fungal endocarditis
Citation
Sri Lanka Journal of Forensic Medicine, Science & Law May 2016 Vol.7 No.1 P. 4 - 7