[Candidosis of the central nervous system in children of the first year--one of the problems in nosocomial fungal infections].
CNS candidosis is a severe disease, one of the nosocomial fungal infections, with often lethal issue or invalidation of the patient. Specific signs are absent and early diagnosis is very difficult. Risk factors are the following: prematurity, candidal carriage, prolonged hospitalization, treatment with broad spectrum antibiotics and immunosupressors, artificial pulmonary ventilation. No single effective antifungal agent exists. In the case of acute fungal CNS infection the drug of choice is fluconazole (diflucan) characterized by high efficacy and CSF sanitation rate, the drug is used intravenously with possible switching off to oral form. If the pathogen is not susceptible to the drug (C. crusel, C. glabrata and C. tropicalis) amphotericin B is recommended (C. lusitaniae is not susceptible). In the case of renal or hepatic failure AmBisome may be used as less toxic form. If the case of prolonged disease antifungal drugs are used in a long-term regime, drugs combinations are also recommended. Complex therapy with granulocyte colony stimulating factor may be used if the previous regime was not effective.
Buslaeva
G N
GN
Russian State Medical University, Moscow.
D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission; D003428:Cross Infection / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008581:Meningitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008590:Meningoencephalitis / Q000188:drug therapy* / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology; D012307:Risk Factors