title: Transplacental transmission of Cryptococcus neoformans to an HIV-exposed premature neonate.
abstract: Cryptococcosis during pregnancy is well documented, but transmission of infection to the fetus is rare. We describe a premature neonate born to a mother with congenitally acquired human immunodeficiency virus (HIV) and active cryptococcosis. Histological examination of the placenta revealed Cryptococcus neoformans within the maternal intervillous space with focal invasion into the chorionic villi. A positive serum cryptococcal antigen (1:2) was detected on days 1 and 5 of life. The neonate had no evidence of central nervous system disease and was treated with fluconazole with resolution of antigenemia. This case highlights both the potential for transplacental transmission of C. neoformans infection and the complexities of caring for pregnant mothers who themselves are congenitally infected with HIV.
authors.affiliation: Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
authors.forename: M
authors.initials: M
authors.lastname: Patel
authors.forename: K P
authors.initials: KP
authors.lastname: Beckerman
authors.forename: S
authors.initials: S
authors.lastname: Reznik
authors.forename: R P
authors.initials: RP
authors.lastname: Madan
authors.forename: D L
authors.initials: DL
authors.lastname: Goldman
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000635:transmission*; D000946:Antigens, Fungal; D002824:Chorionic Villi / Q000473:pathology; D003453:Cryptococcosis / Q000175:diagnosis / Q000635:transmission*; D003455:Cryptococcus neoformans; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000151:congenital*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D008431:Maternal-Fetal Exchange; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D019562:Viral Load; D055815:Young Adult
chemical_list: D000946:Antigens, Fungal