A Case of delayed diagnosis of congenital candidiasis in a Late preterm infant.

Abstract

A female infant was vaginally born at 35 weeks and developed respiratory distress. A rash with pustules gradually appeared on her entire body. Her respiratory condition did not improve with antibacterial treatment. Candida albicans was detected in pharynx, urine, stool, and gastric fluid cultures. Therefore, she was diagnosed with congenital candidiasis (CC) and prescribed fiuconazole. Her respiratory condition rapidly improved after the course of treatment. CC is rare but should be considered in infants with rashes and pustules. Rapid diagnosis is important for a prompt treatment because CC has a high mortality rate, particularly in low-birth-weight infants. However, the diagnosis is challenging when the rash is nonspecific. Paying attention to maternal risk factors, such as the use of intrauterine contraceptive devices, cervical suture, and the use of antibiotics, and to infants' symptoms, including respiratory distress and leukocytosis with left shift may help in a faster diagnosis.