Cases reported "Candidiasis, Cutaneous"

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1/14. Congenital cutaneous candidiasis: clinical presentation, pathogenesis, and management guidelines.

    We describe a term infant with congenital cutaneous candidiasis (CCC), and review all cases in the English literature that reported birth weight and outcome. Presence of an intrauterine foreign body was a predisposing factor for development of CCC and subsequent preterm birth. The most common presentation of CCC in neonates weighing >1000 g was a generalized eruption of erythematous macules, papules, and/or pustules that sometimes evolved to include vesicles and bullae. Extremely low birth weight, premature neonates weighing <1000 g most often presented with a widespread desquamating and/or erosive dermatitis (10 of 15 [67%]), and were at greater risk for systemic infection with Candida spp (10 of 15 [67%]) and death (6 of 15 [40%] than those weighing >1000 g (5 of 48 [10%]; 4 of 48 [8%], respectively). Systemic antifungal therapy is recommended for neonates with burn-like dermatitis attributable to Candida spp, or positive blood, urine, and/or cerebrospinal fluid cultures. Systemic treatment also should be considered for all infants with CCC who have respiratory distress in the immediate neonatal period and/or laboratory signs of sepsis such as an elevated leukocyte count with an increase in immature forms or persistent hyperglycemia and glycosuria.
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2/14. Congenital cutaneous candidiasis.

    Two cases of congenital cutaneous candidiasis are presented in order to call attention to this rarely recognized and infrequently reported condition. Clinical features and appropriate cultures are useful in differentiating the lesions from other more common dermatoses of the neonatal period. Microscopic examination of the placenta may disclose fungal funisitis or chorioamnionitis, thus defining the congenital nature of the disease. Topical antifungal therapy is sufficient unless systemic candidiasis is present. No evidence of impaired immunological responsiveness was found in the two infants.
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3/14. Nail dystrophy in congenital cutaneous candidiasis.

    Congenital cutaneous candidiasis (CCC) is usually a benign condition characterized by various skin manifestations and is rarely associated with nail changes. We report a premature infant with CCC who developed dystrophy of all 20 nails at about 1 month of age. Nail dystrophy due to candida albicans in the young infant may be differentiated from other congenital or hereditary nail malformations by appearance, recovery of the organism in nail culture, and complete resolution over a period of several months.
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4/14. Congenital candidiasis: a rare and unpredictable disease.

    We present a full-term female infant with congenital candidiasis characterized by extensive vesicular and pustular skin lesions associated with pneumonia and severe respiratory distress that appeared during the first hours after birth. The patient was born by cesarean section with no history of rupture of membranes. The mother had a vaginal discharge 3 weeks before delivery. The diagnosis was made by culture of pustular fluid, which grew candida albicans. Systemic cultures were negative. The infant required a very brief course of conventional mechanical ventilation in spite of impressive and extensive lung infiltrates on the chest radiograph. She made a very quick clinical recovery although it is remarkable that antifungal treatment with amphotericin b was begun very late in her clinical course at the time when she was showing obvious signs of major improvement. Current management guidelines strongly recommend specific therapy for infants with invasive congenital candidiasis or with burn-like extensive dermatitis even without lung involvement. We are not suggesting any change in these recommendations; however, at least in our patient, when amphotericin b was started, she was clearly recovering; it seems possible that her disease although extensive might have experienced an unusual spontaneous regression. This case can provide further insights into this unusual neonatal infection.
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5/14. Cutaneous ulcers due to candida albicans in an immunocompromised patient--response to therapy with itraconazole.

    The patient, a 68-year-old female, with chronic anaemia and a previous history of carcinoma of the breast treated surgically, had been receiving therapy with methyl prednisone, in addition to gold, for pemphigus vulgaris. She developed deep cutaneous ulcers on the lower leg. All had well-defined edges and were covered with purulent and serosanguinous exudates. On histopathology the ulcers were deeply infiltrated with yeasts and mycelium and candida albicans was isolated on culture. There was no evidence of systemic candidosis. Complete healing was obtained using itraconazole in a dose of 200 mg daily for 45 days: treatment with prednisone was continued throughout. The response to antifungal therapy alone suggests that Candida was largely, if not wholly responsible, for this unusual clinical condition.
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6/14. Skin rash associated with Candida guilliermondii.

    We report a case in which the development of a skin rash in a neutropenic patient was associated with multiple blood culture isolates of Candida guilliermondii--an unusual isolate not previously documented to cause rashes.
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7/14. Immunologic features of chronic granulomatous mucocutaneous candidiasis before and after treatment with transfer factor.

    We report the acquisition of skin test sensitivity to candida albicans antigen and the ability to produce leukocyte migration inhibition factor (MIF) by a Candida-negative patient with chronic granulomatous mucocutaneous candidiasis after treatment with dialyzable transfer factor (TFd). The TFd was acquired from Candida-positive healthy donors. Three of seven attempts to transfer Candida skin test sensitivity were successful, and the acquired skin reactivity lasted for 12 to 21 days. The acquisition of cellular immunity to Candida was demonstrated in vitro by production of leukocyte MIF. No Candida-induced lymphocyte transformation was observed before or after TFd injection. The TFd did not cause Candida-induced blast transformation when added directly to cultures of lymphocytes from the patient. pain, tenderness, redness, and edema were observed around the Candida granulomas on each occasion when the skin test to Candida became positive. Two weeks after TDd injection, the proliferative response of peripheral blood lymphocytes increased, as measured by incorporation of tritiated thymidine into lymphocytes within the first hour of in vitro incubation.
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8/14. fever, rash, and muscle tenderness. A distinctive clinical presentation of disseminated candidiasis.

    Five patients had fatal, disseminated candidiasis. At the onset of candidemia, a remarkably similar and distinctive triad of high fever, papular erythematous skin lesions, and diffuse severe muscle tenderness developed in each patient. This previously unreported clinical syndrome is sufficiently unique to justify a presumptive diagnosis of disseminated candidiasis and the use of empiric antifungal therapy pending culture and biopsy results.
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9/14. An immunological investigation of a family with chronic mucocutaneous candidiasis.

    Chronic mucocutaneous candidiasis in two siblings of consanguineous parents suggested an autosomal recessive transmission of the disease. We evaluated the two affected persons and 21 members of their kindred for an inherited immunological defect. Six members of the kindred, including both patients, had negative skin-delayed hypersensitivity to Candida. The lymphocytes of both patients and three asymptomatic relatives had diminished in vitro blastogenic response when cultured with candida albicans. Because the defect occurred in clinically unaffected relatives, we concluded that the lack of blastogenic response to C. albicans was not the only determinant for or may be unrelated to the clinical manifestations of the disease.
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10/14. Liposomal amphotericin-B (AmBisome) for treatment of cutaneous widespread candidosis in an infant with methylmalonic acidaemia.

    In a 10-week-old infant with vitamin B12-unresponsive methylmalonic acidaemia, cutaneous candidosis (candida albicans) progressed rapidly despite topical antifungal treatment. After 1 week of intravenous therapy with liposomal amphotericin-B (AmBisome) the dermatitis disappeared completely and blood cultures were sterile. No side-effects were observed. This is one of the first experiences in the treatment of infants with this new antifungal agent.
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