title: Two cases of systemic Candida glabrata infection following in vitro fertilization and embryo transfer.
abstract: Presented here are two cases of systemic Candida glabrata infection diagnosed in two expectant mothers and their fetuses at 34 and 22 weeks' gestation. The underlying risk factors in case 1 were in vitro fertilization and embryo transfer, recurrent yeast vaginitis and two intravenous injections of betamethasone. The risk factors in case 2 were in vitro fertilization and embryo transfer, recurrent yeast vaginitis, antibiotics for treatment of a urinary tract infection due to Morganella morganii and amniocentesis. In both cases, vaginal fluid yielded growth of a yeast that was not identified. Candida glabrata was isolated from samples obtained from the mothers and their babies. Since Candida glabrata lacks hyphae, membranitis and infection of the fetuses were demonstrated only on slides stained with Gomori Grocott and periodic acid-Schiff. Both cases suggest that for such pregnancies the follow-up of vaginal fluid should include the identification of any yeasts grown on selective Candida medium. In case of premature rupture of membranes, systematic sampling of mothers and their infants or fetuses should be associated with microscopic study of placentas, membranes and stillborn fetuses with Gomori Grocott and periodic acid-Schiff staining techniques.
authors.affiliation: Department of Microbiology, Brest University Hospital, 29609 Brest Cedex, France.
authors.forename: A S
authors.initials: AS
authors.lastname: Ibara
authors.forename: P
authors.initials: P
authors.lastname: Marcorelles
authors.forename: M T
authors.initials: MT
authors.lastname: Le Martelot
authors.forename: N
authors.initials: N
authors.lastname: Touffet
authors.forename: E
authors.initials: E
authors.lastname: Moalic
authors.forename: G
authors.initials: G
authors.lastname: Hery-Arnaud
authors.forename: J D
authors.initials: JD
authors.lastname: Giroux
authors.forename: A M
authors.initials: AM
authors.lastname: Le Flohic
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D041221:Candida glabrata / Q000302:isolation & purification*; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004624:Embryo Transfer / Q000009:adverse effects*; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D016469:Fungemia / Q000175:diagnosis* / Q000188:drug therapy; D005865:Gestational Age; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011272:Pregnancy, Multiple; D018570:Risk Assessment; D012720:Severity of Illness Index; D014427:Twins
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents