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Clinical and microbiological characteristics of Candida meningitis/ventriculitis in children

Yıl 2022, Cilt 3, Sayı 3, 235 - 240, 30.09.2022

Öz

Background: Candida meningitis/ventriculitis is rather rare during childhood. In this study, we investigated the clinical characteristics, risk factors, treatment, and prognosis of patients with Candida meningitis/ventriculitis.

Methods: Patients under the age of 18 years who were diagnosed with Candida meningitis/ventriculitis were evaluated retrospectively.

Results: A total of 10 cases with Candida meningitis/ventriculitis were analyzed. Three patients (30%) were below the age of one, and two (20%) were neonates. The two most common underlying conditions were hydrocephalus shunt and prematurity. Predisposing factors were a history of broad-spectrum antibiotic use, external ventricular drainage, total parenteral nutrition, central venous catheter, and staying in intensive care. The cerebrospinal fluid culture was positive in all patients, and 10% (1/1) had bacteremia. Of the isolates, 50% were C. albicans, 30% were C. tropicalis, 10% were C. lusitaniae, and 10% were C. dubliniensis. Fluconazole treatment was initiated in four (40%) and voriconazole in three (30%) patients. Two patients received combined treatment (amphotericin B + fluconazole/voriconazole). The median treatment duration was 38.6 days (range: 16–70 days). Three patients received intraventricular Amphotericin B.Central nervous system devices which were assumed to be infected were removed. A complication of endophthalmitis developed in one patient. The mortality rate was 10%.

Conclusions: Among agents causing meningitis/ventriculitis, Candida should also be kept in mind in premature neonates and patients with ventricular-peritoneal shunts. The history of antibiotic use and external ventricular drainage are important predisposing factors. It can be successfully treated with fluconazole, voriconazole, amphotericin B, and removal of the central nervous system device.

Kaynakça

  • 1. Kauffman CA. Candida infections of the central nervous system [updated 26 Apr 2022. Available at: https://www.uptodate.com/ contents/candida-infections-of-the-central-nervous-system?search= Candida-infections-of-the-central-nervoussystem&source=search_ result&selectedTitle=1~150&usage_type=default&display_rank=1. Accessed July 22, 2022
  • 2. Campbell JR, Palazzi DL. Candida infections in children [updated 12 Nov 2019. Available at: https://www.uptodate.com/ contents/ candida-infections-in-children?search=%20Candida%20 %E2%80%93infections-%20in%20-children.&source=search_ result&selectedTitle=1~150&usage_type=default&display_rank=1.
  • 3. Romero J, Jacobs R. Fungal Meningitis. In: Cherry J HG, Kaplan SL,Steinbach WJ, Hotez PJ, editor. Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia: Elsevier; 2019. p.345-9.
  • 4. Cohen-Wolkowiez M, Smith PB, Mangum B, Steinbach WJ, Alexander BD, Cotten CM, et al. Neonatal Candida meningitis: significance of cerebrospinal fluid parameters and blood cultures. J Perinatol. 2007 Feb;27(2):97-100.
  • 5. Prevention CfDCa. Fungal Meningitis Available at: https://www. cdc.gov/FungalMeningitis/about.html/detail/namingthe-Parasites. Accessed July 22, 2022
  • 6. Sánchez-Portocarrero J, Pérez-Cecilia E, Corral O, Romero-Vivas J, Picazo JJ. The central nervous system and infection by Candida species. Diagn Microbiol Infect Dis. 2000;37(3):169-79.
  • 7. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky- Zeichner L, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-50.
  • 8. Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Scheld WM, et al. 2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis. 2017;64(6):e34-e65.
  • 9. Arisoy ES, Arisoy AE, Dunne WM, Jr. Clinical significance of fungi isolated from cerebrospinal fluid in children. Pediatr Infect Dis J. 1994;13(2):128-33.
  • 10. Bilgin E, Ökten A, Gezercan Y, Çavuş G, Açık V, Arslan A, et al. Pediatric Giant Cerebral Candida Abscess: A Case Report. Pediatr Neurosurg. 2019;54(3):207-211.
  • 11. Fernandez M, Moylett EH, Noyola DE, Baker CJ. Candidal meningitis in neonates: a 10-year review. Clin Infect Dis. 2000;31(2):458-63.
  • 12. Xu L, Zhao H, Zhou M, Lang G, Lou H. Single and Repeated Episodes of Candida Species Isolated From Cerebrospinal Fluid for Diagnosing Probable Candida meningitis. Front Microbiol. 2021;12:742931.
  • 13. McCullers JA, Vargas SL, Flynn PM, Razzouk BI, Shenep JL. Candidal meningitis in children with cancer. Clin Infect Dis. 2000;31(2):451-7.
  • 14. Chen M, Chen C, Yang Q, Zhan R. Candida meningitis in neurosurgical patients: a single-institute study of nine cases over 7 years. Epidemiology and infection. 2020;148:e148.
  • 15. Chiou CC, Wong TT, Lin HH, Hwang B, Tang RB, Wu KG, et al. Fungal infection of ventriculoperitoneal shunts in children. Epidemiol Infect. 2020;148:e148.
  • 16. Sariguzel FM, Koc AN, Ozturk M. Candida Utilis and Candida lusitaniae Meningitis in an infant with extraventricular drainage. Van Tıp Derg. 2017;24:40-3.
  • 17. Baradkar VP, Mathur M, Sonavane A, Kumar S. Candidal infections of ventriculoperitoneal shunts. J Pediatr Neurosci. 2009;4(2):73-5.
  • 18. Yamahiro A, Lau KH, Peaper DR, Villanueva M. Meningitis Caused by Candida Dubliniensis in a Patient with Cirrhosis: A Case Report and Review of the Literature. Mycopathologia. 2016;181(7-8):589-93.
  • 19. Xie H, Luo P, Li Z, Li R, Sun H, Wu D. Continuous intrathecal administration of liposomal amphotericin B for treatment of refractory Cryptococcus neoformans encephalitis: A case report. Exp Ther Med. 2017;14(1):780-784.
  • 20. Yuan L, Chen F, Sun Y, Zhang Y, Ji X, Jin B. Candida meningitis in an infant after abdominal surgery successfully treated with intrathecal and intravenous amphotericin B: A case report. Medicine. 2021;100(37):e27205.
  • 21. Chaussade H, Cazals X, Desoubeaux G, Jouvion G, Bougnoux ME, Lefort A, et al. Central nervous system candidiasis beyond neonates: Lessons from a nationwide study. Med Mycol. 2021;59(3):266-277.

Yıl 2022, Cilt 3, Sayı 3, 235 - 240, 30.09.2022

Öz

Kaynakça

  • 1. Kauffman CA. Candida infections of the central nervous system [updated 26 Apr 2022. Available at: https://www.uptodate.com/ contents/candida-infections-of-the-central-nervous-system?search= Candida-infections-of-the-central-nervoussystem&source=search_ result&selectedTitle=1~150&usage_type=default&display_rank=1. Accessed July 22, 2022
  • 2. Campbell JR, Palazzi DL. Candida infections in children [updated 12 Nov 2019. Available at: https://www.uptodate.com/ contents/ candida-infections-in-children?search=%20Candida%20 %E2%80%93infections-%20in%20-children.&source=search_ result&selectedTitle=1~150&usage_type=default&display_rank=1.
  • 3. Romero J, Jacobs R. Fungal Meningitis. In: Cherry J HG, Kaplan SL,Steinbach WJ, Hotez PJ, editor. Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia: Elsevier; 2019. p.345-9.
  • 4. Cohen-Wolkowiez M, Smith PB, Mangum B, Steinbach WJ, Alexander BD, Cotten CM, et al. Neonatal Candida meningitis: significance of cerebrospinal fluid parameters and blood cultures. J Perinatol. 2007 Feb;27(2):97-100.
  • 5. Prevention CfDCa. Fungal Meningitis Available at: https://www. cdc.gov/FungalMeningitis/about.html/detail/namingthe-Parasites. Accessed July 22, 2022
  • 6. Sánchez-Portocarrero J, Pérez-Cecilia E, Corral O, Romero-Vivas J, Picazo JJ. The central nervous system and infection by Candida species. Diagn Microbiol Infect Dis. 2000;37(3):169-79.
  • 7. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky- Zeichner L, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-50.
  • 8. Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Scheld WM, et al. 2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis. 2017;64(6):e34-e65.
  • 9. Arisoy ES, Arisoy AE, Dunne WM, Jr. Clinical significance of fungi isolated from cerebrospinal fluid in children. Pediatr Infect Dis J. 1994;13(2):128-33.
  • 10. Bilgin E, Ökten A, Gezercan Y, Çavuş G, Açık V, Arslan A, et al. Pediatric Giant Cerebral Candida Abscess: A Case Report. Pediatr Neurosurg. 2019;54(3):207-211.
  • 11. Fernandez M, Moylett EH, Noyola DE, Baker CJ. Candidal meningitis in neonates: a 10-year review. Clin Infect Dis. 2000;31(2):458-63.
  • 12. Xu L, Zhao H, Zhou M, Lang G, Lou H. Single and Repeated Episodes of Candida Species Isolated From Cerebrospinal Fluid for Diagnosing Probable Candida meningitis. Front Microbiol. 2021;12:742931.
  • 13. McCullers JA, Vargas SL, Flynn PM, Razzouk BI, Shenep JL. Candidal meningitis in children with cancer. Clin Infect Dis. 2000;31(2):451-7.
  • 14. Chen M, Chen C, Yang Q, Zhan R. Candida meningitis in neurosurgical patients: a single-institute study of nine cases over 7 years. Epidemiology and infection. 2020;148:e148.
  • 15. Chiou CC, Wong TT, Lin HH, Hwang B, Tang RB, Wu KG, et al. Fungal infection of ventriculoperitoneal shunts in children. Epidemiol Infect. 2020;148:e148.
  • 16. Sariguzel FM, Koc AN, Ozturk M. Candida Utilis and Candida lusitaniae Meningitis in an infant with extraventricular drainage. Van Tıp Derg. 2017;24:40-3.
  • 17. Baradkar VP, Mathur M, Sonavane A, Kumar S. Candidal infections of ventriculoperitoneal shunts. J Pediatr Neurosci. 2009;4(2):73-5.
  • 18. Yamahiro A, Lau KH, Peaper DR, Villanueva M. Meningitis Caused by Candida Dubliniensis in a Patient with Cirrhosis: A Case Report and Review of the Literature. Mycopathologia. 2016;181(7-8):589-93.
  • 19. Xie H, Luo P, Li Z, Li R, Sun H, Wu D. Continuous intrathecal administration of liposomal amphotericin B for treatment of refractory Cryptococcus neoformans encephalitis: A case report. Exp Ther Med. 2017;14(1):780-784.
  • 20. Yuan L, Chen F, Sun Y, Zhang Y, Ji X, Jin B. Candida meningitis in an infant after abdominal surgery successfully treated with intrathecal and intravenous amphotericin B: A case report. Medicine. 2021;100(37):e27205.
  • 21. Chaussade H, Cazals X, Desoubeaux G, Jouvion G, Bougnoux ME, Lefort A, et al. Central nervous system candidiasis beyond neonates: Lessons from a nationwide study. Med Mycol. 2021;59(3):266-277.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıp
Bölüm ORIGINAL ARTICLE
Yazarlar

Ümmühan ÇAY>
Çukurova University Faculty of Medicine,Department of Pediatric Infectious Diseases, Adana, Turkey
0000-0001-5803-878X
Türkiye


Nisa Nur TAPAÇ>
Çukurova University Faculty of Medicine,Department of Pediatric Infectious Diseases, Adana, Turkey
0000-0002-7464-2394
Türkiye


Adnan BARUTÇU> (Sorumlu Yazar)
ÇUKUROVA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI, SOSYAL PEDİATRİ BİLİM DALI
0000-0001-8930-1122
Türkiye


Derya ALABAZ>
Çukurova University Faculty of Medicine,Department of Pediatric Infectious Diseases, Adana, Turkey
0000-0003-4809-2883
Türkiye


Özlem ÖZGÜR GÜNDEŞLİOĞLU>
Çukurova University Faculty of Medicine,Department of Pediatric Infectious Diseases, Adana, Turkey
0000-0003-2202-7645
Türkiye


Filiz KİBAR>
Çukurova University Faculty of Medicine, Department of Microbiology, Adana, Turkey
0000-0003-2983-2399
Türkiye


Kadir OKTAY>
Çukurova University Faculty of Medicine, Department of Neurosurgery, Adana, Turkey
0000-0003-2420-2734
Türkiye

Yayımlanma Tarihi 30 Eylül 2022
Başvuru Tarihi 14 Haziran 2022
Kabul Tarihi 22 Eylül 2022
Yayınlandığı Sayı Yıl 2022, Cilt 3, Sayı 3

Kaynak Göster

APA Çay, Ü. , Tapaç, N. N. , Barutçu, A. , Alabaz, D. , Özgür Gündeşlioğlu, Ö. , Kibar, F. & Oktay, K. (2022). Clinical and microbiological characteristics of Candida meningitis/ventriculitis in children . Archives of Current Medical Research , 3 (3) , 235-240 . Retrieved from https://dergipark.org.tr/tr/pub/acmr/issue/72847/1130724

Archives of Current Medical Research (ACMR) provides instant open access to all content, bearing in mind the fact that presenting research

free to the public supports a greater global exchange of knowledge.

http://www.acmronline.org/