Persistent Candida albicans Infection of A Cerebrospinal Fluid Shunt Infection Unresponsive to Amphotericin B Treatment Because of Increased Minimum Inhibitory Concentration

Abstract

Enfeksiyon şant uygulamalarında halen en sık görü- len komplikasyondur. Mantar enfeksiyonları nadir olmakla birlikte ciddi morbidite ve mortalite ile ilişkilidir. Prematüre yenidoğanlarda ve beyin ameliyatlarından sonra bu risk artar. Bu makalede, tedavi sırasında artmış MIC değeri nedeniyle amphoterisin B tedavisi- ne cevap vermeyip vorikonazol ile flusitozin tedavisine cevap veren beyin omurilik sıvısı (BOS)da tekrarla- yan Candida albicans üremeleri ile giden şant enfek- siyonlu bir olgu sunulmuştur. (J Pediatr Inf 2015; 9: 181-4)

Infection is still the most common complication of shunt procedures in children. However fungal infec- tion is considered to be rare, it is also associated with significant morbidity and mortality. The risk is increas- ing in premature neonates and after neurosurgery. Herein, we present a preterm neonate with persistant Candida albicans cerebrospinal fluid (CSF) shunt infection that was unresponsible to amphotericin B treatment due to increased minimal inhibitory concen- tration (MIC) during the therapy period and later which was treated by voriconazole plus flucytosine. (J Pediatr Inf 2015; 9: 181-4)