Treatment of neonatal fungal infective endocarditis with recombinant tissue plasminogen: activator in a low birth weight infant case report and review of the literature

Mycoses. 2015 Oct;58(10):578-81. doi: 10.1111/myc.12359. Epub 2015 Jul 27.

Abstract

With advances in medical sciences, an increase in survival rates of low birth weight; increased incidence in use of catheter and antibiotics, and total parenteral nutrition are reported, therefore, the rate of fungal infections in late and very late onset neonatal sepsis have increased. Although fungal endocarditis rarely occur in newborns, it has a high morbidity and mortality. Antifungal therapy is often insufficient in cases who develop fungal endocarditis and surgical treatment is not preferred due to its difficulty and high mortality. Herein, fungal endocarditis in a preterm newborn treated with single-dose recombinant tissue plasminogen activator in addition to antifungal therapy is presented and relevant literature has been reviewed. The vegetation completely disappeared following treatment and no complication was observed.

Keywords: Candida albicans; fungal endocarditis; prematurity; recombinant tissue activator.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antifungal Agents / therapeutic use*
  • Brain / microbiology
  • Candida albicans / growth & development
  • Candida albicans / isolation & purification*
  • Candidiasis, Invasive / drug therapy*
  • Candidiasis, Invasive / microbiology
  • Echocardiography
  • Endocarditis / drug therapy*
  • Endocarditis / microbiology
  • Escherichia coli / isolation & purification
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Heart / microbiology
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / drug therapy*
  • Infant, Premature, Diseases / microbiology*
  • Infant, Very Low Birth Weight
  • Sepsis / drug therapy
  • Sepsis / microbiology
  • Tissue Plasminogen Activator / therapeutic use*

Substances

  • Antifungal Agents
  • Fibrinolytic Agents
  • Tissue Plasminogen Activator