Ophthalmologic, visceral, and cardiac involvement in neonates with candidemia

A retrospective review of 86 neonates with candidemia hospitalized from Jan uary 1989 through June 1999 was conducted to determine the frequency of oph thalmologic, visceral, or cardiac involvement. Retinal abnormalities were o bserved in 4 (6%) of the 67 infants in whom indirect ophthalmoscopy examina tion was performed. Abdominal ultrasound abnormalities were detected in 5 ( 7.7%) of 65 infants. Echocardiogram revealed thrombi or vegetations in 11 ( 15.2%) of 72 infants. Age at onset, presence of central venous catheters, a nd species of Candida were not predictors for involvement at these sites. I nfants with candidemia that lasted greater than or equal to5 days were more likely to demonstrate ophthalmologic, renal, or cardiac abnormalities than those with a shorter duration. Infants with involvement of these organs re ceived larger cumulative doses of amphotericin B than those without detecta ble abnormalities. Because complication of disseminated candidiasis by eye, renal, or cardiac involvement has therapeutic implications, and because ri sk factors for candidemia inadequately predict these complications, evaluat ions are indicated for all neonates with candidemia.