Candida (Amphotericin-Sensitive) Lens Abscess Associated With Decreasing Arterial Blood Flow in a Very Low Birth Weight Preterm Infant

In this report, we review the case of a candidal lens abscess in a premature infant girl who was 28 weeks' gestational age at birth. The culture obtained from the lens abscess grew Candida albicans sensitive to amphotericin B but resistant to flucytosine. This case is unique in that the infant...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2002-11, Vol.110 (5), p.e65-e65
Main Authors: Drohan, Laura, Colby, Christopher E, Brindle, Mary E, Sanislo, Steven, Ariagno, Ronald L
Format: Article
Language:English
Subjects:
Abscess - drug therapy
Abscess - surgery
Amphotericin B - therapeutic use
Antifungal Agents - therapeutic use
Candida albicans
Candidiasis
Candidiasis - drug therapy
Candidiasis - surgery
Care and treatment
Cataract Extraction
Endophthalmitis
Eye infections
Eye Infections, Fungal - drug therapy
Eye Infections, Fungal - surgery
Female
Flucytosine - therapeutic use
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Lens Diseases - drug therapy
Lens Diseases - surgery
Lens, Crystalline - blood supply
Lens, Crystalline - embryology
Lens, Crystalline - surgery
Ophthalmic Artery - embryology
Pediatrics
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Summary:In this report, we review the case of a candidal lens abscess in a premature infant girl who was 28 weeks' gestational age at birth. The culture obtained from the lens abscess grew Candida albicans sensitive to amphotericin B but resistant to flucytosine. This case is unique in that the infant developed a fungal lens cataract at 34 weeks' postconceptional age during the last week of a 30-day course of amphotericin B. The embryonic hyaloid artery system, which perfuses the developing lens, regresses between 29 and 32 weeks of gestation; thus, the mechanism for an infection of the lens may be inoculation of the lens by Candida before hyaloid artery system regression, followed by developmental loss of this blood supply, which makes the lens inaccessible to antimicrobial penetration. Candidal endophthalmitis with lens abscess is an uncommon morbidity that requires prompt recognition and surgical intervention for effective management.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.110.5.e65