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Clinical analysis on the 16 cases of premature neonatal fungal septicemia

ZHANG Pei;XIA Shi-wen;LIU Yong;Dept. of Newborn,Hubei Provincial Maternal and Children Health Care Institute;  
Objective To study the clinical characteristics of premature neonatal fungal septicemia in order to improve diagnostic accuracy and treatment efficacy. Methods The general condition,time of onset,first presenting symptom,thrombocyte,C-reactive protein,1,3-β-D-glycan,blood culture results,infection indicators were analysed retros pectively in 16 cases of newborns with fungal sepsis who admitted to author's neonatal intensive care unit from January,2013 to September,2014;and changes of thrombocyte,C-reactive protein and 1,3-β-Dglycan were compared between before,during and after treatment. Results Candida tropicalis was the major pathogen of neonatal fungal sepsis;the onset time spanned 5-36 days after birth [an averaged of(14±5.5)days];the most common presenting symptoms were feeding intolerance,frequent apnea,poor response,and fever;thrombocytopenia and increased C-reactive protein level and 1,3-beta glucan D were seen in most patients,after7 days of antifungal treatment,the platelets of the majority of the patients could rise to normal,CRP and 1,3-beta glucan D decrease to normal after 2 week of antifungal treatment. Admiistration of fluconazole and caspofungin could achieve satisfactory results for neonatal candida septicemia. Conclusion Premature neonatal fungal septicemia showed no specific clinical manifestations;but thrombocytopenia,increased 1,3-beta glucan D may be early considered fungal infections in the newborns with risk factors it should also be highly alerted to the possibility of fungal infection,Fluconazole is still primary and first-line drugs in the treatment of neonatal fungal,septicemia early detection and prompt treatment are the key elements to successful treatment.
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