Congenital candidiasis

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Potentially catastrophic: In premature and low birth weight may cause “Invasive fungal dermatitis”
 
Mechanism
  • Acquired in utero, but may not be apparent at birth (≠ neonatal candidiasis, which is aquired during delivery)
 
Risk factors:
  • foreign body in uterus or cervix,
  • premature delivery,
  • maternal history of vaginal candidiasis
 
Clinical presentation:
  • Maculopapular rash within 12h after birth that becomes pustular
  • Pustular involvement of palms and soles
  • May just have isolated nail changes
  • “burn-like”, respiratory distress, elevated white blood cell count, other signs of systemic toxicity
 
Approach:
  • do cultures of blood, urine, CSF (avoid lumbar puncture if overlying skin affected). Also umbilical cord and placenta if available
 
Treatment
  • topical azol, amphotericin B if high risk or sign of disseminated disease