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Clinical Features of Neonatal Candida Meningitis and Usefulness of Ultrasound Examination

감염과화학요법 2005년 37권 5호 p.280 ~ 287
김지영, 최병규, 김천수, 이희정, 이상락, 권태찬,
소속 상세정보
김지영 ( Kim Ji-Young ) - 계명대학교 의과대학 소아과학교실
최병규 ( Choi Byung-Kyu ) - 계명대학교 의과대학 소아과학교실
김천수 ( Kim Chun-Soo ) - 계명대학교 의과대학 소아과학교실
이희정 ( Lee Hee-Jung ) - 계명대학교 의과대학 진단방사선과
이상락 ( Lee Sang-Lak ) - 계명대학교 의과대학 소아과학교실
권태찬 ( Kwon Tae-Chan ) - 계명대학교 의과대학 소아과학교실

Abstract


Background: Candida species are becoming one of the most common pathogens associated with nosocomial infection in the neonatal intensive care units (NICU). This study was undertaken to investigate the clinical features and radiologic findings of meningitis complicating candida sepsis in the neonates.

Materials & Methods: Seventy-two neonates with Candida sepsis admitted to the NICU of Dongsan Medical Center, Keimyung University from Jan. 1997 to Dec. 2003 were enrolled. Medical records and serial radiologic images were reviewed retrospectively performed.

Results: Among a total of 72 patients with candida sepsis, meningitis developed in 12 cases (17%) and C. albicans was the only causative organism. Cerebrospinal fluid (CSF) analysis:showed pleocytosis in 9 cases (75%), protein elevation and candidal isolation in 7 cases (58%) each, and hypoglycorrhachia in 3 cases (25%). Of the 66 cases that underwent serial ultrasound examination, multiple cerebral microabscess was observed in 9 cases (14%); these lesions were also found on the brain MRI taken after the end of treatment in 7 cases (78%). In 2 cases (17%) without initial abnormal CSF findings, diagnosis was made through early ultrasound examination. In limited study of 49 neonates with C. albicans sepsis, demographic characteristics and risk factors between two groups (group 1:with meningitis, group 2:without meningitis) were similar, but fever or seizure at the onset of infection was more common in group 1 (P<0.05). The mortality rate was also higher in group 1, but it was not statistically significant.

Conclusion: Candida meningitis is common in neonates with C. albicans sepsis and findings of CSF study were variable. Therefore, serial ultrasound examination may be of help in making correct diagnosis of central nervous system involvement.

키워드

Candida albicans;Meningitis;Neonate;Ultrasound Examination

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