Background

Cutaneous congenital candidiasis (CCC) is a rare condition consisting of invasive fungal infection of the epidermis and dermis that mostly affects preterm infants. Maternal vaginal candidiasis is present in half of the cases, although the occurrence of invasive candidiasis during pregnancy or peripartum period is exceptional.

Case report

We present the case of a full-term infant that was born by vacuum-assisted vaginal delivery to an apparently healthy 33 year-old woman with no history of intravenous drug use or vaginal candidiasis during pregnancy. The newborn showed a diffuse maculopapular rash with respiratory distress and bilateral interstitial lung infiltrates, requiring nasal continuous positive airway pressure support. Blood cultures obtained from the mother due to intrapartum fever yielded Candida albicans. Cultures of vaginal discharge and neonate skin also yielded C. albicans with the same in vitro susceptibly pattern. No alternative source for candidemia was identified. The clinical course after starting a systemic antifungal therapy was favorable in both the mother and the neonate, with clearance of candidemia and resolution of the skin lesions.

Conclusions

CCC must be considered in full-term newborns with maculopapular rash at birth or during the first days of life. The absence of alternative sources for bloodstream infection in the present case suggests a potential etiopathogenic relationship between CCC and maternal candidemia. It is reasonable to rule out postpartum candidemia when CCC is suspected.

中文翻译：

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先天性皮肤念珠菌病与产妇围产期念珠菌血症有关。

背景

皮肤先天性念珠菌病 (CCC) 是一种罕见的疾病，由表皮和真皮的侵袭性真菌感染组成，主要影响早产儿。尽管在怀孕或围产期发生侵袭性念珠菌病的情况很少见，但有一半的病例存在母体阴道念珠菌病。

案例报告

我们介绍了一个足月婴儿的案例，该婴儿通过真空辅助阴道分娩出生于一名明显健康的 33 岁妇女，在怀孕期间没有静脉注射药物使用史或阴道念珠菌病史。新生儿表现为弥漫性斑丘疹伴呼吸窘迫和双肺间质浸润，需要鼻持续气道正压通气支持。由于产时发热从母亲身上获得的血培养产生白色念珠菌。阴道分泌物和新生儿皮肤的培养也产生了白色念珠菌具有相同的体外敏感模式。没有确定念珠菌血症的替代来源。开始全身抗真菌治疗后的临床过程对母亲和新生儿都是有利的，念珠菌血症清除和皮肤病变消退。

结论

对于出生时或出生后头几天出现斑丘疹的足月新生儿，必须考虑 CCC。本病例中没有其他血流感染来源表明 CCC 与母体念珠菌血症之间存在潜在的病因关系。当怀疑 CCC 时，排除产后念珠菌血症是合理的。