Candidal Meningitis in Neonates: A 10-Year Review

Fernandez, M.; Moylett, E. H.; Noyola, D. E.; Baker, C. J.

doi:10.1086/313973

Cited by 163Antifungal resistance and susceptibilityNeonatal and Maternal InfectionsFungal Infections and Studies

Candidal Meningitis in Neonates: A 10-Year Review

Fernandez, M., Moylett, E. H., Noyola, D. E., Baker, C. J.·2000·Clinical Infectious Diseases

DOI 10.1086/313973

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Abstract

Candidal meningitis may complicate systemic candidiasis in the premature neonate. We conducted a 10-year retrospective review of 106 cases of systemic candidiasis in neonates to define the incidence, clinical features, laboratory findings, treatment, and outcome of candidal meningitis. Twenty-three of the 106 neonates had candidal meningitis (0.4% of admissions to the neonatal intensive care unit). The median gestational age was 26.2 weeks, the median birth weight was 820 g, and the median age at the onset of illness was 8 days. Clinical disease was severe and commonly was manifested by respiratory decompensation. Findings of cerebrospinal fluid (CSF) analyses varied: pleocytosis was inconsistent, hypoglycorrhachia was common, gram staining was uniformly negative, and Candida was isolated from 17 neonates (74%). Each infant was treated with amphotericin B (median cumulative dose, 30 mg/kg); 5 also received flucytosine therapy. In conclusion, initial clinical features of candidal meningitis are indistinguishable from those of other causes of systemic infection in premature neonates, and normal CSF parameters do not exclude meningitis. Timely initiation of amphotericin B monotherapy was associated with an excellent outcome.

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Candida meningitis often follows candidemia in newborn infants and has a high propensity for relapse.
“Candida meningitis often follows candidemia in newborn infants [234] and has a high propensity for relapse.”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [234]

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Authors: Fernandez, M., Moylett, E. H., Noyola, D. E., & Baker, C. J.
Affiliations: Baylor College of Medicine (US)
Corresponding author: Baker, C. J.
ORCID: Fernandez, M.
Noyola, D. E.
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 2000-08-01
Volume: 31
Issue: 2
Pages: 458-463
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1086/313973
OpenAlex: W2104856050
Cited by: 163
References: 25
Citations by year: 2026: 2 · 2025: 6 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 7 · 2020: 8 · 2019: 7 · 2018: 9 · 2017: 7 · 2016: 8 · 2015: 9 · 2014: 5 · 2013: 8 · 2012: 6
FWCI: 4.43
Type: journal article
Language: en
Open access: closed
Locations: Clinical Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords: systemic candidiasis, preterm infants, amphotericin B, 5-fluorocytosine, cerebrospinal fluid findings, hypoglycorrhachia, respiratory decompensation, incidence, treatment outcomes
MeSH terms: Antifungal Agents, Candida, Candidiasis, Female, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Male, Retrospective Studies, Incidence, Meningitis, Fungal

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Candidal Meningitis in Neonates: A 10-Year Review

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