title: Candida glabrata sepsis associated with chorioamnionitis in an IVF twin pregnancy: Should we deliver?
abstract: We report a case of in vitro fertilization (IVF)-acquired Candida glabrata chorioamnionitis successfully treated through systemic maternal antifungal treatment prior to delivery. To the best of our knowledge, this is the first case of its kind in the literature. C. glabrata chorioamnionitis in pregnancy is rare, but the current literature suggests a very high fetal fatality in such cases. It is known to have an association with cervical stitch, amniocentesis, chorionic villous sampling, and assisted reproductive techniques such as IVF. Given the increasing global use of artificial reproductive techniques, it is important to raise awareness of this condition and highlight its potential complications. Early recognition of possible fetal infection could enable early initiation of systemic antifungal treatment. It would be prudent to consider early delivery once fetal maturity is achieved despite normal fetal monitoring.
authors.affiliation: Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
authors.forename: Shu Qi
authors.initials: SQ
authors.lastname: Tan
authors.affiliation: Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.
authors.forename: Oon Tek
authors.initials: OT
authors.lastname: Ng
authors.affiliation: Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
authors.forename: Chit Chong
authors.initials: CC
authors.lastname: Khong
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001034:Apgar Score; D041221:Candida glabrata / Q000187:drug effects / Q000302:isolation & purification*; D058387:Candidemia / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D059285:Pregnancy, Twin / Q000187:drug effects; D047928:Premature Birth / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents
keywords: Candida glabrata; chorioamnionitis; in vitro fertilization pregnancy; timing of delivery