先天性十二指腸閉鎖症の術後に発症し,DIC,眼内炎を合併した新生児カンジダ血症の1例

抄録

We report a case of disseminated candidiasis in a patient with congenital duodenal atresia. A full-term male infant, birth weight 2,540g, was admitted to our hospital on day 2 because of bile vomitus with severe dehydration and metabolic alkalosis, Duodeno-duodenostomy was performed on day 5 for congenital duodenal atresia. He had been given cefotaxim and amikacin postoperatively and progressed well until the 4th postoperative day when he developed a temperature of 38.4℃. Several different antibiotics were tried but fever continued. His general condition worsened and finally complications developed, including DIG. Frequent exchange blood transfusions antifungal drugs (Amphotericin B and 5-Fluorocytosin) were effective in curing the DIG and eliminating positive Candidas of the blood, CFS, urine and skin lesions. On the 73rd postoperative day an indirect fundoscopic examination showed 2 white lesions in his right fund us and one white lesion in his left fundus. His left eye lesion developed a vitreous lesion despite antifungal therapy, although the right eye lesion disappeared. On the 117th postoperative day antifungal drugs were discontinued, although one small lesion in his left eye remained. The lesion is gradually improving 3 months after discontinuation of the drugs.