Conservative approach for intra-amniotic Candida albicans colonisation. Case report and review of current evidence.

IF 0.2 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Perinatal Medicine Pub Date : 2025-06-11 eCollection Date: 2025-01-01 DOI:10.1515/crpm-2024-0047

Beatriz Bové, Irene Barragán, Laia Pratcorona, Roser Porta, Raül de Diego, Ma Carmen Comas, María Méndez, Carlos Rodrigo Gonzalo de Liria

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引用次数: 0

Abstract

Objectives: Intra-amniotic colonisation or infection caused by Candida albicans is rare. Given the shortage of reported cases, evidence on antifungal strategies and the choice of type and timing of delivery is limited.

Case presentation: We report a case of intra-amniotic colonisation by C. albicans in a pregnant woman with a previous history of cervical cerclage and candidal vaginosis at 25 weeks of gestational age (GA). The diagnosis was made following preterm premature rupture of membranes at GA 28 weeks and 6 days. Treatment was started with amphotericin B and was replaced by fluconazole due to an anaphylactic reaction. The persistence of C. albicans in the amniotic fluid after 24 days of treatment prompted the decision to plan an elective caesarean delivery at 32 weeks' GA. The infant showed no signs of fungaemia and had an uneventful clinical course after 14 days of treatment with fluconazole.

Conclusions: Conservative management with intravenous fluconazole in pregnant women with intra-amniotic colonisation by C. albicans at early GA, can contribute to the prolongation of pregnancy while protecting the foetus from fungal disease.

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羊膜内白色念珠菌定植的保守方法。案件报告和现有证据的审查。

目的：由白色念珠菌引起的羊膜内定植或感染是罕见的。鉴于报告病例的短缺，抗真菌策略和递送类型和时间选择的证据是有限的。病例介绍：我们报告一例羊膜内由白色念珠菌定殖的孕妇宫颈环切和念珠菌阴道病的历史在25周孕龄（GA）。诊断是在GA 28周零6天发生胎膜早破。治疗开始使用两性霉素B，由于过敏反应改用氟康唑。治疗24天后羊水中白色念珠菌的持续存在促使我们决定在孕32周时计划择期剖腹产。在氟康唑治疗14天后，婴儿未出现真菌血症的症状，临床过程平稳。结论：对妊娠早期羊膜内白色念珠菌定植的孕妇静脉注射氟康唑进行保守治疗，有助于延长妊娠期，同时保护胎儿免受真菌疾病的侵害。

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来源期刊

Case Reports in Perinatal Medicine OBSTETRICS & GYNECOLOGY-

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期刊介绍： Case Reports in Perinatal Medicine is a double-blind peer-reviewed journal. The objective of the new journal is very similar to that of JPM. In addition to evidence-based studies, practitioners in clinical practice esteem especially exemplary reports of cases that reveal specific manifestations of diseases, its progress or its treatment. We consider case reports and series to be brief reports describing an isolated clinical case or a small number of cases. They may describe new or uncommon diagnoses, unusual outcomes or prognosis, new or infrequently used therapies and side effects of therapy not usually discovered in clinical trials. They represent the basic concept of experiences for studies on representative groups for further evidence-based research. The potential roles of case reports and case series are: Recognition and description of new diseases Detection of drug side effects (adverse or beneficial) Study of mechanisms of disease Medical education and audit Recognition of rare manifestations of disease.