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.
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References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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.
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.
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.
• 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.
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.
•• 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.
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.
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.
•• 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.
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.
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.
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.
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.
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.
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.
• 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.
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.
Rowen JL, Atkins JT, Levy ML, Baer SC, Baker CJ. Invasive fungal dermatitis in the <1000-gram neonate. Pediatrics. 1995;95:682–7.
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.
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.
Aguin TJ, Sobel JD. Vulvovaginal candidiasis in pregnancy. Curr Infect Dis Rep. 2015;17:30. https://doi.org/10.1007/s11908-015-0462-0.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by SPAP and TBME. The first draft of the manuscript was written by SPAP and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Alicia Sanchez-Padilla, Adriana Valencia-Herrera, Mirna Toledo-Bahena, Carlos Mena-Cedillos, Mario Duarte-Abdala, Marcela Salazar-Garcia and Alexandro Bonifaz declare no conflicts of interest relevant to this manuscript.
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This article is part of the Topical Collection on Fungal Infections of Skin and Subcutaneous Tissue
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Sánchez-Padilla, A.P., Valencia-Herrera, A.M., Toledo-Bahena, M.E. et al. Congenital Cutaneous Candidiasis: Uncommon Entity or Underdiagnosed?. Curr Fungal Infect Rep 13, 175–180 (2019). https://doi.org/10.1007/s12281-019-00359-1
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DOI: https://doi.org/10.1007/s12281-019-00359-1