• Gaole Yuan, Yingqiu Tu, Lili Liu, and Tiantian Xu.
• The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi China.
• Medicine (Baltimore). 2021 Dec 30; 100 (52): e28270e28270.

RationaleCandida bloodstream infection continues to be a significant cause of mortality in premature infants. Amphotericin B has been recommended as the primary treatment; however, its use is limited due to drug-induced nephrotoxicity and amphotericin B-resistant candidemia.Patient ConcernsThe gestational age was 29 (+6) weeks, and birth weight was 1760 g.DiagnosisThe infant was diagnosed with Candida parapsilosis bloodstream infection.InterventionsFluconazole, 12 mg/kg/day, combined with caspofungin (loading dose 3 mg/kg, at a maintenance dose of 2 mg/kg every 24 h) therapy was administered to premature infant with Candida bloodstream infection. When fluconazole or caspofungin was used to treat Candida bloodstream infection in preterm infants, the blood cultures of the infant remained positive for Candida parapsilosis.OutcomesAll persistent candidemia resolved on fluconazole combined with caspofungin therapy. There were no adverse effects, hepatotoxicity, nephrotoxicity, anemia, or thrombocytopenia.LessonsFluconazole combined with caspofungin successfully treated Candida bloodstream infection in premature infants at 29 + 6 weeks' gestational age, but large-scale clinical trials are required.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

32 keywords...

hide…