Top

Published in:

01-12-2019 | Amphotericin B | Fungal Infections of Skin and Subcutaneous Tissue (A Bonifaz and M Pereira, Section Editors)

Congenital Cutaneous Candidiasis: Uncommon Entity or Underdiagnosed?

Authors: A. P. Sánchez-Padilla, A. M. Valencia-Herrera, M. E. Toledo-Bahena, C. A. Mena-Cedillos, M. Duarte-Abdala, M. Salazar-García, Alexandro Bonifaz

Published in: Current Fungal Infection Reports | Issue 4/2019

Abstract

Purpose of Review

We have created a general review of the disease in this article, especially of the clinical features, diagnosis, new treatments and preventive measures.

Summary

Congenital cutaneous candidiasis is a vertically transmitted fungal infection which affects term and premature newborn. It is considered as an underdiagnosed pathology, and infection caused by Candida albicans is considered the most common aetiology.

Recent Findings

Clinically characterized by erythematous papular lesions and pustules with collarette scale. It can also affect other organs and systems by causing an invasive fungal infection. Diagnosis is clinical, and the agent can be isolated; other tools of diagnosis include direct examination and skin biopsy. Regarding the treatment, this infection can be self-limiting in a majority of cases and topical antifungals constitute the treatment of choice. However, in the case of a systemic condition, the first-line treatment is amphotericin B. Prognosis is good, although it is unfavourable in the case of a systemic condition.

Sonnenschein H, Clark HL, Taschdjian CL. Congenital cutaneous candidiasis in a premature infant. Am J Dis Child. 1960;99:81–5. https://doi.org/10.1001/archderm.1977.01640080103019.CrossRef

Whyte RK. Hussain Z, deSa D. Antenatal infections with Candida species. Arch Dis Child. 1982;57:528–35. https://doi.org/10.1136/adc.57.7.528.CrossRefPubMedPubMedCentral

Blanc WA. Pathways of fetal and early neonatal infection: viral placentitis, bacterial and fungal chorioamnionitis. J Pediatr. 1961;59:473–96. https://doi.org/10.1016/s0022-3476(61)80232-1.CrossRefPubMed

• Darmstadt GL, Dinulos JG, Miller Z. Congenital cutaneous candidiasis: clinical presentation, patogenesis and management guidelines. Pediatrics. 2000;105:438–44. https://doi.org/10.1542/peds.105.2.438This article describes the main associated risk factors. CrossRefPubMed

Saiman L, Ludington E, Pfaller M, et al. Risk factors for candidemia in neonatal intensive care unit patients. The national epidemiology of mycosis survey study group. Pediatr Infect Dis J. 2000;19:319–24. https://doi.org/10.1097/00006454-200004000-00011.CrossRefPubMed

•• Mendling W, Brasch J. Guideline vulvovaginal candidosis of the german society for gynecology and obstetrics, the working group for infections and infectimmunology in gynecology and obstetrics, the german society of dermatology, the board of german dermatologists and the german speaking mycological society. Mycoses. 2012;55:1–13. https://doi.org/10.1111/j.1439-0507.2012.02185.xThis article is a review of the disease, focused on preventive measures. CrossRefPubMed

Gürgan T, Diker KS, Haziroglu R, Urman B, Akan M. In vitro infection of human fetal membranes with Candida species. Gynecol Obstet Invest. 1994;37:164–7. https://doi.org/10.1159/000292549.CrossRefPubMed

Schwartz DA, Reef S. Candida albicans placentitis and funisitis: early diagnosis of congenital candidemia by histopathologic examination of umbilical cord vessels. Pediatr Infect Dis J. 1990;9:661–5.CrossRef

•• Kaufman DA, Coggins SA, Zanelli AZ, Weitkamp JH. Congenital cutaneous candidiasis: prompt systemic treatment is associated with improved outcomes in neonates. Clin Infec Dis. 2017;64(10):1387–95. https://doi.org/10.1093/cid/cix119This article describes the clinical features and main aetiology. CrossRef

10.

Clegg HW, Prose NS, Greenberg DN. Nail dystrophy in congenital cutaneous candidiasis. Pediatr Dermatol. 2003;20:342–4. https://doi.org/10.4103/0019-5154.77564.CrossRefPubMed

11.

Kaufman DA, Fairchild KD. Clinical microbiology of bacterial and fungal sepsis in very-low-birth-weight infants. Clin Microbiol Rev. 2004;17:638–80. https://doi.org/10.1128/CMR.17.3.638-680.2004.CrossRefPubMedPubMedCentral

12.

Manzoni P, Castagnola E, Mostert M, et al. Hyperglycaemia as a posible marker of invasive fungal infection in preterm neonates. Acta Paediatr. 2006;95(4):486–93. https://doi.org/10.1080/08035250500444867.CrossRefPubMed

13.

Diana A. EpineyM, Ecoffey M, Pfister RE. “White dots on the placenta and red dots on the baby”: congenital cutaneous candidiasis: a rare disease of the neonate. Acta Paediatr. 2004;93(7):996–9. https://doi.org/10.1080/08035250410028093.CrossRefPubMed

14.

Jagtap SA, Saple PP, Dhaliat SB. Congenital cutaneous candidiasis: a rare and unpredictable disease. Indian J Dermatol. 2011;56(1):92–3. https://doi.org/10.4103/0019-5154.77564.CrossRefPubMedPubMedCentral

15.

Rowen JL, Tate JM. Management of neonatal candidiasis. Neonatal candidiasis study group. Pediatr Infect Dis J. 1998;17:1007–11. https://doi.org/10.1097/00006454-199811000-00008.CrossRefPubMed

16.

• Sáez-Llorens X, Macias M, Maiya P, Pineros J, Hafri H, Chatterjee A, et al. Pharmacokinetics and safety of caspofungin in neonates and infants less than 3 months of age. Antimicrob Agents Chemother. 2009;53:869–75. https://doi.org/10.1128/AAC.00868-08This article describes new treatments. CrossRefPubMed

17.

Hope W, Smith B, Arrieta A, Buell D, Roy M, Kaibara A, et al. The pharmacokinetics and pharmacodynamics of micafungin in experimental hematogenous Candida meningoencephalitis: implications for echinocandin therapy in neonates. J Infect Dis. 2008;197:163–71. https://doi.org/10.1086/524063.CrossRefPubMedPubMedCentral

18.

Rowen JL, Atkins JT, Levy ML, Baer SC, Baker CJ. Invasive fungal dermatitis in the <1000-gram neonate. Pediatrics. 1995;95:682–7.PubMed

19.

Van der Elst K, Pereboom M, Van den Heuvel E, Kosterink J, Schölvinck E, Alffenaar JW. Insufficient fluconazole exposure in pediatric cancer patients and the need for therapeutic drug monitoring in critically ill children. Clin Infec Dis. 2014;59(11):1527–33. https://doi.org/10.1093/cid/ciu657.CrossRef

20.

Oza V, Asch S, Mathes EF. Three-day-old boy with palmar pustules. JAMA Pediatr. 2016;170:171–2. https://doi.org/10.1001/jamapediatrics.2015.1996.CrossRefPubMed

21.

Aguin TJ, Sobel JD. Vulvovaginal candidiasis in pregnancy. Curr Infect Dis Rep. 2015;17:30. https://doi.org/10.1007/s11908-015-0462-0.CrossRef

Title: Congenital Cutaneous Candidiasis: Uncommon Entity or Underdiagnosed?
Authors: A. P. Sánchez-Padilla
A. M. Valencia-Herrera
M. E. Toledo-Bahena
C. A. Mena-Cedillos
M. Duarte-Abdala
M. Salazar-García
Alexandro Bonifaz
Publication date: 01-12-2019
Publisher: Springer US
Keywords: Amphotericin B
Candida Balanitis
Candidiasis
Candida Albicans
Candidiasis
Published in: Current Fungal Infection Reports / Issue 4/2019
Print ISSN: 1936-3761
Electronic ISSN: 1936-377X
DOI: https://doi.org/10.1007/s12281-019-00359-1

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose of Review

Summary

Recent Findings

Please log in to get access to this content

Other articles of this Issue 4/2019

The Manaus Declaration: Current Situation of Histoplasmosis in the Americas, Report of the II Regional Meeting of the International Histoplasmosis Advocacy Group

Tinea Gladiatorum: an Update

Pityriasis Versicolor in Children and Adolescents: an Update

From Culture to Fungal Biomarkers: the Diagnostic Route of Fungal Infections in Children with Primary Immunodeficiencies

Small-Molecule Protein Kinases Inhibitors and the Risk of Fungal Infections

Epidemiology of Endemic Mycosis in Children

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials