Rare Case: CNS Candidiasis with CKD in Neonate

Abstract

Background: Candida infections are a common cause of mortality and morbidity in NICU. 70% of neonates with systemic fungal infection develop brain abscess. Candidiasis can involve the renal cortex resulting in impairment of renal function. Clinical Description: A neonate presented with features of severe dehydration on Day 16 of life with chief complaints of loose stool and vomiting, weight loss was of 24% Baby was exclusively breastfed. Lab inv was s/o severe metabolic acidosis with raised urea and creatinine. MRI Brain s/o fungal abscess.USG KUB s/o B/L small shrunken Echogenic Kidney so a diagnosis of CKD was made. Management: Baby was mechanically ventilated due to respiratory distress and FFP transfusion was given due to deranged PT/INR and inotropes were started. Dehydration and sodium bicarbonate correction was given. Antibiotics were started Antifungals (Amphotericin B and Fluconazole were started). Conclusion: Candida albicans is the most common fungal infection that is seen among late onset fungal sepsis. In disseminated Candidiasis, kidneys are most commonly involved followed by brain. Thus, becomes very crucial to have an early diagnosis of disseminated candidiasis for better prognosis.

Keywords

• candida albicans
• disseminated candidiasis
• ckd
• fungal abscess