Successful management of a cutaneous abscess caused by Candida albicans in a very low birth weight neonate

Abstract

Fungal sepsis is a sinister infection in the neonatal intensive care unit associated with significant mortality and neurodevelopment sequelae. Very low birth weight and very preterm neonates are often predisposed and manifestations range from mucocutaneous to invasive organ involvement. Prompt recognition and treatment with appropriate antifungal improve survival and neurodevelopmental outcomes. In this report, we describe a neonate with rare dermatological manifestation in the form of a cutaneous fungal abscess with urinary tract involvement. The diagnosis was based on budding yeast cells seen on pus smear examination and culture suggestive of Candida albicans. Risk factors included birth weight <1500 g, placement of central vascular catheter, endotracheal tube, parenteral nutrition, surgical intervention, and use of broad-spectrum antibiotics. Amphotericin B deoxycholate and incision and drainage of the abscess were done to manage the abscess successfully. This report highlights the consideration of Candida as an etiological agent for cutaneous abscesses, in case of preterms with risk factors for fungal infection. Evaluation for systemic dissemination is mandatory and management with appropriate antifungal agents is critical for survival.