Multi-resistant fungal sepsis in a neonatal ICU – Case Report

Abstract

 Introduction: Neonatal sepsis (NS) is a clinical syndrome characterized by systemic clinical manifestations, especially hemodynamic changes, resulting from the presence of pathogenic microorganisms in normally sterile fluid, in the first month of the newborn's life. NS is an important cause of neurocognitive sequelae and neonatal mortality. Clinically, it is characterized by signs and symptoms related to infection in the first month of life, with or without bacteremia. The main causative agent of NS is the fungus of the genus Candida sp. Case report: Newborn (NB) with a gestational age of 36 weeks and 4 days required neonatal resuscitation. At 24 hours of life, he presented with septic shock, seizures, apnea and pulmonary hypertension, requiring antibiotic therapy. The results of the tracheal aspirate culture showed the fungus Candida parapsilosis, sensitive to the drug micafungin sodium. Discussion: Fungal infections are commonly associated with morbidity and mortality in preterm newborns with gestational age <32 weeks and birth weight <1,500g. It should be noted that there are obvious clinical presentations, such as respiratory difficulty, apnea, lethargy, fever or hypothermia, jaundice without another determining cause, vomiting and diarrhea, or even cutaneous manifestations, including petechiae, abscess and scleredema, which were observed in the newborn in the first 24 hours of life. Regarding the treatment of invasive candidiasis in the newborn whose case is reported, drug therapy with sodium micafungin was instituted. Conclusion: The diagnosis of NS, in the first hours of the newborn's life, was essential for the institution of therapy, preventing death.