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Nguyen TQN, Nguyen TV, Pham TN, Ha TKO. Hepatic abscess due to Candida species in neonates: Case reports in Vietnam. IDCases 2023; 34:e01904. [PMID: 37822875 PMCID: PMC10563005 DOI: 10.1016/j.idcr.2023.e01904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/30/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023] Open
Abstract
Neonatal hepatic abscess (NHA) is a fatal condition in neonates. NHA can be caused by many organisms including bacteria, parasites, and fungi. Fungal NHA is a rare but troublesome cause in terms of diagnosis and treatment. We present three cases of fungal NHA caused by Candida. In these three cases, different underlying problems associated with NHA had been found.
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Affiliation(s)
- Thi Quynh Nga Nguyen
- Hanoi Medical University, Viet Nam
- Vietnam National Children’s Hospital, Viet Nam
| | | | - Thao Nguyen Pham
- Hanoi Medical University, Viet Nam
- Vietnam National Children’s Hospital, Viet Nam
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Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010167. [PMID: 36676116 PMCID: PMC9864123 DOI: 10.3390/life13010167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/30/2022] [Accepted: 01/03/2023] [Indexed: 01/08/2023]
Abstract
(1) Background: Although invasive fungal infections are a major cause of neonatal morbidity and mortality, data on the incidence and outcomes of localized abscesses in solid organs due to fungal infections are scarce. The aim of this study was to consolidate evidence and enhance our understanding on neonatal liver abscesses due to invasive fungal infections. (2) Methods: An electronic search of the PubMed and Scopus databases was conducted, considering studies that evaluated fungal liver abscesses in the neonatal population. Data on the epidemiology, clinical course, treatment, and outcome of these infections were integrated in our study. (3) Results: Overall, 10 studies were included presenting data on 19 cases of neonatal fungal liver abscesses. Candida spp. were the most common causative pathogens (94.7%). Premature neonates constituted the majority of cases (93%), while umbilical venous catheter placement, broad spectrum antibiotics, and prolonged parenteral nutrition administration were identified as other common predisposing factors. Diagnosis was established primarily by abdominal ultrasonography. Medical therapy with antifungal agents was the mainstay of treatment, with Amphotericin B being the most common agent (47%). Abscess drainage was required in four cases (21%). Eradication of the infection was achieved in the majority of cases (80%). (4) Conclusions: Even though fungal liver abscess is a rare entity in the neonatal population, clinicians should keep it in mind in small, premature infants who fail to respond to conventional treatment for sepsis, particularly if an indwelling catheter is in situ. A high index of suspicion is necessary in order to achieve a timely diagnosis and the initiation of the appropriate treatment.
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Eisi H, Ibraheem S, Hisham T, Al-Harbi A, Saidy K, Ali I, Nour I, Nasef N. Risk factors and outcomes of deep tissue Candida invasion in neonates with invasive candidiasis. Mycoses 2021; 65:110-119. [PMID: 34780084 DOI: 10.1111/myc.13395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Deep tissue Candida invasion represents a special entity among neonates with invasive candidiasis. We aimed to explore the risk factors and clinical outcomes for deep tissue Candida invasion among neonates with invasive candidiasis. METHODS A retrospective data review of neonates admitted to NICU of Madinah maternity and children hospital, KSA from January 2012 to December 2019 was done. Data were analysed between infants with or without deep tissue candidiasis among infants with invasive candidiasis. Invasive candidiasis was defined as positive blood or catheter collected urine culture for Candida. Deep tissue Candida invasion was defined as an infection of the central nervous system, eyes, heart, skeletal system, lungs, liver or kidneys. RESULT A total of 14 (11%) out of 130 neonates with invasive candidiasis had deep tissue Candida invasion. Persistent positive blood culture for Candida [OR 15.2, 95% CI (2.0-114), p = .01], prematurity [OR 7.6, 95% CI (1.04-56.4), p = .04] and prolonged antibiotic duration [OR 1.3, 95% CI (1.02-1.6), p = .03] are independent risk factors for deep tissue Candida invasion. Deep tissue Candida invasion was associated with significantly higher rates of cerebral palsy, hydrocephalus, heart failure and longer length of hospital stay compared to infants without deep tissue invasion. CONCLUSION Persistent Candida growth in blood cultures, prematurity and long-term antibiotic use are significant risk factors for deep tissue Candida invasion. Deep tissue Candida invasion is associated with prolonged hospital stay and higher neonatal morbidity.
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Affiliation(s)
- Hanin Eisi
- Neonatal Intensive Care Unit, Madina Maternity and Children's Hospital, King Salman Medical City, Madina, Saudi Arabia
| | - Shohood Ibraheem
- Neonatal Intensive Care Unit, Madina Maternity and Children's Hospital, King Salman Medical City, Madina, Saudi Arabia
| | - Tooba Hisham
- Neonatal Intensive Care Unit, Madina Maternity and Children's Hospital, King Salman Medical City, Madina, Saudi Arabia
| | - Aziza Al-Harbi
- Neonatal Intensive Care Unit, Madina Maternity and Children's Hospital, King Salman Medical City, Madina, Saudi Arabia
| | - Khalid Saidy
- Neonatal Intensive Care Unit, Madina Maternity and Children's Hospital, King Salman Medical City, Madina, Saudi Arabia
| | - Ismail Ali
- Department of Diagnostic Radiology, Madina Maternity and Children's Hospital, King Salman Medical City, Madina, Saudi Arabia.,Faculty of Medicine, Department of Diagnostic Radiology, University of Zagazig, Zagazig, Egypt
| | - Islam Nour
- Neonatal Intensive Care Unit, Madina Maternity and Children's Hospital, King Salman Medical City, Madina, Saudi Arabia.,Faculty of Medicine, Department of Pediatrics, University of Mansoura, Mansoura, Egypt
| | - Nehad Nasef
- Neonatal Intensive Care Unit, Madina Maternity and Children's Hospital, King Salman Medical City, Madina, Saudi Arabia.,Faculty of Medicine, Department of Pediatrics, University of Mansoura, Mansoura, Egypt
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Gibson K, Sharp R, Ullman A, Morris S, Kleidon T, Esterman A. Risk factors for umbilical vascular catheter-related adverse events: A scoping review. Aust Crit Care 2021; 35:89-101. [PMID: 34088575 DOI: 10.1016/j.aucc.2021.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Adverse events associated with umbilical catheters include malposition, bloodstream infections, thrombosis, tip migration, and extravasation, resulting in loss of vascular access and increased risk of morbidity and mortality. There is a need for greater understanding of risk factors associated with adverse events to inform safe practice. OBJECTIVES The aim of the study was to summarise the existing evidence regarding risk factors for umbilical catheter-related adverse events to inform the undertaking of future research. REVIEW METHOD USED A scoping review of peer-reviewed original research and theses was performed. DATA SOURCES The US National Library of Medicine National Institutes of Health, Embase, EMcare, and ProQuest Dissertations and Theses were the data sources. REVIEW METHODS Informed by the Joanna Briggs Institute Reviewer's Manual, all types of original research studies reporting adverse events published in English from 2009 to 2020 were eligible for inclusion. Studies where umbilical artery catheter and umbilical venous catheter data could not be extracted separately were excluded. RESULTS Searching identified 1954 publications and theses, 1533 were excluded at screening, and 418 were assessed for eligibility at full text. A total of 89 studies met the inclusion criteria. A range of potential risk factors for umbilical arterial and venous catheters were identified. Longer dwell time and prematurity were associated with increased risk of bloodstream infection and thrombosis in cohort studies. Case studies detailed analogous factors such as insertion techniques and lack of catheter surveillance during dwell warrant further investigation. CONCLUSIONS We identified a vast range of patient, device, and provider risk factors that warrant further investigation. There was a lack of large cohort studies and randomised controlled trials to demonstrate the significance of these risk factors. Improvement in methods to ensure correct catheter tip location and to detect adverse events early is essential. In addition, policy needs to be developed to guide clinicians in catheter surveillance measures to reduce the risk of adverse events.
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Affiliation(s)
- Kim Gibson
- Clinical and Health Sciences, University of South Australia, PO Box 2471, South Australia, 5000, Australia.
| | - Rebecca Sharp
- Clinical and Health Sciences, University of South Australia, PO Box 2471, South Australia, 5000, Australia.
| | - Amanda Ullman
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Nathan Campus, 170 Kessels Road Queensland 4111, Australia; Children's Health Queensland and Health Service Centre of Children's Health Research, South Brisbane QLD 4101, Australia; School of Nursing, Midwifery and Social Work The University of Queensland, Brisbane QLD 4072, Australia.
| | - Scott Morris
- College of Medicine and Public Health, Flinders University, Neonatal Unit, Flinders Medical Centre, Bedford Drive, Bedford Park, South Australia 5042, Australia.
| | - Tricia Kleidon
- Queensland Children's Hospital, 401 Stanley Street, South Brisbane, Q. 4101, Australia; School of Nursing and Midwifery, Griffith University, 170 Kessels Raod, Nathan, Q. 4111, Australia.
| | - Adrian Esterman
- Clinical and Health Sciences, University of South Australia, PO Box 2471, South Australia, 5000, Australia.
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Kaur T, Vig V, Kaur I, Arora S. Fungal choroidal abscess in a case of aggressive retinopathy of prematurity. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2021. [DOI: 10.4103/jcor.jcor_213_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bersani I, Piersigilli F, Goffredo BM, Santisi A, Cairoli S, Ronchetti MP, Auriti C. Antifungal Drugs for Invasive Candida Infections (ICI) in Neonates: Future Perspectives. Front Pediatr 2019; 7:375. [PMID: 31616647 PMCID: PMC6764087 DOI: 10.3389/fped.2019.00375] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/02/2019] [Indexed: 12/26/2022] Open
Abstract
Fungal infections may complicate the neonatal clinical course, and the spectrum of therapies for their treatment in the perinatal period is limited. Polyenes, Azoles and Echinocandins represent the three classes of antifungal drugs commonly used in the neonatal period. The present review provides an overview about the most recent therapeutic strategies for the treatment of fungal infections in neonates.
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Affiliation(s)
- Iliana Bersani
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Fiammetta Piersigilli
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Bianca Maria Goffredo
- Biochemistry Laboratory, Department of Specialist Pediatrics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Alessandra Santisi
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Sara Cairoli
- Biochemistry Laboratory, Department of Specialist Pediatrics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Maria Paola Ronchetti
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Cinzia Auriti
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, Rome, Italy
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Intrahepatic Administration of Liposomal Amphotericin B (Ambisome) for the Management of a Liver Abscess from Candida albicans in a Preterm Infant. Antimicrob Agents Chemother 2018; 62:AAC.01239-18. [PMID: 30224526 DOI: 10.1128/aac.01239-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/02/2018] [Indexed: 12/24/2022] Open
Abstract
Hepatic fungal abscesses are rare in the neonatal period and often constitute a severe complication of the catheterization of the umbilical vessels. Such life-threatening lesions are observed more frequently in preterm than in other newborn infants and the optimal treatment remains uncertain. We present the case of a preterm neonate, who developed an intrahepatic lesion due to parenteral extravasation, successively contaminated by Candida albicans Despite the maximal pharmacological therapies, the treatment that led to the definitive resolution of the abscess was the placement of surgical drainage followed by the direct intralesional administration of liposomal amphotericin B (Ambisome), never described in neonates in the literature, which turned out to be a safe and effective approach.
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Fiore M, Cascella M, Bimonte S, Maraolo AE, Gentile I, Schiavone V, Pace MC. Liver fungal infections: an overview of the etiology and epidemiology in patients affected or not affected by oncohematologic malignancies. Infect Drug Resist 2018; 11:177-186. [PMID: 29416363 PMCID: PMC5790101 DOI: 10.2147/idr.s152473] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Fungal infections of the liver, most commonly caused by Candida spp., often occur in patients with hematologic malignancies treated with chemotherapy. Colonization of the gastrointestinal tract is thought to be the main origin of dissemination of Candida; mucositis and neutropenia facilitate the spread of Candida from the gastrointestinal tract to the liver. Hepatic involvement due to other fungi is a less common infectious complication in this setting. Fungal infections represent a less common cause of hepatic abscesses in non-oncohematologic population and the trend appears to be decreasing in recent years. Understanding of the etiology and epidemiology of fungal infections of the liver is indicated for an appropriate antimicrobial therapy and an overall optimal management of fungal liver infections.
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Affiliation(s)
- Marco Fiore
- Department of Anaesthesiological, Surgical and Emergency Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Cascella
- Department of Support for Clinical Activities and Critical Area, Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Via Mariano Semmola, Naples, Italy
| | - Sabrina Bimonte
- Department of Support for Clinical Activities and Critical Area, Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Via Mariano Semmola, Naples, Italy
| | - Alberto Enrico Maraolo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Vincenzo Schiavone
- Division of Anesthesia and Intensive Care, Hospital "Pineta Grande", Castel Volturno, Italy
| | - Maria Caterina Pace
- Department of Anaesthesiological, Surgical and Emergency Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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Khan NA, Choudhury SR, Jhanwar P. Ruptured Liver Abscess in Neonates: Report of Two Cases. J Neonatal Surg 2016; 5:31. [PMID: 27433449 PMCID: PMC4942431 DOI: 10.21699/jns.v5i3.335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 02/19/2016] [Indexed: 11/11/2022] Open
Abstract
Neonatal hepatic abscess is a rare disease seen mainly in preterm following umbilical catheterisation. Liver abscess in term neonates without any predisposing factor is still rarer and only few cases have been reported in the literature. Here we report two cases of liver abscess in term neonates presenting with abdominal mass due to rupture.
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Affiliation(s)
- Niyaz Ahmed Khan
- Department of Paediatric Surgery, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi
| | - S R Choudhury
- Department of Paediatric Surgery, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi
| | - Praveen Jhanwar
- Department of Paediatric Surgery, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi
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