amphotericin-b and Ductus-Arteriosus--Patent

A 6-month-old female infant, with a birth weight of 2.74 kilograms, was born with multiple congenital abnormalities, including gastric and gastrointestinal defects. She was admitted to the hospital with hematemesis. The patient could not be fed orally, and parenteral nutrition was initiated through a central venous catheter. Following pyloroplasty, she developed superior vena cava syndrome, renal disfunction and episodes of sepsis. Stool and respiratory specimens were negative for fungi, but four blood cultures yielded Hansenula anomala var. anomala. Cultures for fungi from intravenous catheter tips were negative. The baby was treated with amphotericin B (am B) and 5-fluorocytosine (5-FC), (amB; 0.1 mg/kg body weight and 5-FC, 100 mg, q.i.d.). The minimal inhibitory concentrations of am B, 5-FC, am B + 5-FC (1:1, w:w) and fluconazole to H. anomala were 1.56, less than 0.195, 1.56, and 1.56 micrograms, respectively. Following antifungal therapy and removal of the catheter, the patient tolerated oral feeding and, at the time of discharge, her weight had increased to 4.91 kg. This report records H. anomala as an opportunistic yeast pathogen for the first time in Alberta, Canada. Previously published cases of H. anomala infections are reviewed.

Topics: Abnormalities, Multiple; Amphotericin B; Ductus Arteriosus, Patent; Duodenum; Female; Fungemia; Hematemesis; Humans; Infant; Pichia

The advancement of neonatology over the past 20 years has allowed a greater number of ELBW infants to survive. However, these advancements have contributed to the increased incidence of acute kidney injury (AKI) seen in this population. Understanding the risk factors for AKI in this population of ELBW infants is imperative for the successful survival of these infants since the morbidity and mortality rates from this disease are increasing.. 1) to determine the prevalence of AKI in ELBW (<  750 grams). 2) to compare the mortality rate of ELBW infants (<  750 grams) with and without AKI; and 3) to identify the associated risk factors of AKI in ELBW infants (<  750 grams).. A retrospective chart review of all infants with AKI as defined by AKIN criterias, admitted to the NICU between 1998 and 2008 was conducted. Case-controls were matched for BW, gestational age and date of birth, (SPSS v17.0 software, using Student's t test, X2 test, and Mann-Whitney U test were used for statistical analysis.. The prevalence rate of ELBW infants (<  750 grams) with AKI admitted at CHMCA NICU from 1998 to 2008 was 26% . The mortality rate of ELBW infants (<  750 grams) with AKI was 54% , compared to 20% in those ELBW infants who did not have AKI. The associated risk factors of AKI in the ELBW infants (<  750 grams) were as follows: presence of maternal placental abruption/bleeding, grade III or IV IVH, PDA, positive culture/s, NEC, use of steroid, nephrotoxic drugs, and longer use of the ventilator and TPN.

Topics: Abruptio Placentae; Acute Kidney Injury; Adult; Amphotericin B; Anti-Bacterial Agents; Case-Control Studies; Cefotaxime; Clindamycin; Creatinine; Diuretics; Ductus Arteriosus, Patent; Enterocolitis, Necrotizing; Female; Furosemide; Humans; Hydrochlorothiazide; Infant, Extremely Low Birth Weight; Infant, Newborn; Infections; Intracranial Hemorrhages; Ohio; Parenteral Nutrition, Total; Pregnancy; Prevalence; Respiration, Artificial; Retrospective Studies; Risk Factors; Steroids; Survival Rate; Time Factors; Uterine Hemorrhage; Vancomycin; Young Adult

Occurrence of neonatal circulatory collapse imposes effective differential diagnosis and expeditious therapeutic intervention. We report a case of neonatal cardiogenic shock, caused by a massive intra-cardiac fungal vegetation.

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Cardiopulmonary Bypass; Ductus Arteriosus, Patent; Echocardiography, Transesophageal; Female; Flucytosine; Humans; Infant, Newborn; Shock, Cardiogenic; Tricuspid Valve; Ventricular Outflow Obstruction

Two infants recovered from endogenous Candida endophthalmitis. Case 1, to the best of my knowledge, is the first reported full term neonate with this entity. Free-floating vitreous opacitis ("ballon vitréen") were found in one infant and the second infant's lesions resolved in a more conventional manner.

Topics: Amphotericin B; Candidiasis; Ductus Arteriosus, Patent; Endophthalmitis; Female; Flucytosine; Humans; Infant; Infant, Newborn; Infant, Premature; Intestinal Obstruction; Intestine, Small; Male; Nystatin; Oxygen