CENTRAL-NERVOUS-SYSTEM CANDIDIASIS IN VERY-LOW-BIRTH-WEIGHT PREMATURENEONATES AND INFANTS - US CHARACTERISTICS AND HISTOPATHOLOGIC AND MR-IMAGING CORRELATES IN 5 PATIENTS

PURPOSE: To analyze the high-resolution tie, 5.0- or 7.5-MHz) ultrason ographic (US) characteristics of central nervous system (CNS) candidia sis and their histopathologic and magnetic resonance (MR) imaging corr elates in very-low-birth-weight (VLBW) premature neonates and infants with systemic candidiasis. MATERIALS AND METHODS: The US images obtain ed in one VLBW neonate (age, 24 days;weight, 846 g) and four VLBW infa nts (age range, 36-161 days; weight rage, 800-1,360 g) with proved CNS candidiasis complicating systemic candidiasis and the clinical (n = 5 ), histopathologic (n = 3), and MR imaging (n = 2) correlates were ret rospectively reviewed. RESULTS: The cranial US findings consisted of p arenchymal abnormalities in four and ventricular lesions in three pati ents. The most common findings were multiple echogenic, rimlike microa bscesses (four patients) scattered in the subcortical, periventricular , and basal ganglial areas. Confluent macroabscess formation, seen as echogenic masslike lesions with hypoechoic centers in the periventricu lar regions and/or thalami, was noted on the US images obtained in two patients. The ventricles showed dilatation in two, increased ependyma l echogenicity in three, the presence in intraventricular echogenic se ta in two, and a lumpy choroid plexus or the presence of debris in two patients. US findings correlated well with MR imaging and autopsy fin dings. The histopathologic changes in the posterior fossa were well de monstrated on MR images but not demonstrated on 5.0- or 7.5-MHz US ima ges. CONCLUSION: CNS candidiasis in VLBW neonates and infants has char acteristic US features that may help in the early diagnosis of CNS inv olvement in systemic candidiasis.