SYSTEMIC MATERNOFETAL CANDIDA-ALBICANS IN FECTION

Maternofetal Candida albicans infection is rare and potentially seriou s. Contamination occurs before or during birth. Risk factors include p resence of a foreign body in the uterus and use by the mother of antim icrobials and/or glucococorticoids. Premature infants are more likely to have poor outcomes than full-term infants. Four cases of maternofet al C. albicans infection seen over a two-year period in the south of t he Reunion Island are reported. The incidence rate was 1/2 500 births per year. One patient was full-term, two were premature (28 and 29 wee ks gestational age), and one died in utero at 27 weeks gestational age . Respiratory distress syndrome was the most prominent manifestation i n the three live-born infants, whereas a maculopapular rash was incons istent. Laboratory tests showed marked leukocytosis and fibrinogen ele vation with normal C-reactive protein levels, suggesting the diagnosis and leading to early intravenous fluconazole therapy. Microbiological studies confirmed the diagnosis. All three patients achieved a full r ecovery. In conclusion, the diagnosis of maternofetal C. albicans infe ction rests on a suggestive history and on a constellation of clinical and laboratory test abnormalities. Complications can be prevented by initiating appropriate therapy as soon as the diagnosis is suspected, even in full-term infants.