Abstract
Maternofetal Candida albicans infection is rare and potentially serious. Contamination occurs before or during birth. Risk factors include presence of a foreign body in the uterus and use by the mother of antimicrobials and/or glucococorticoids. Premature infants are more likely to have poor outcomes than full-term infants. Four cases of maternofetal C. albicans infection seen over a two-year period in the south of the Reunion Island are reported. The incidence rate was 1/2 500 births per year. One patient was full-term, two were premature (28 and 29 weeks gestational age), and one died in utero at 27 weeks gestational age. Respiratory distress syndrome was the most prominent manifestation in the three live-born infants, whereas a maculopapular rash was inconsistent. Laboratory tests showed marked leukocytosis and fibrinogen elevation with normal C-reactive protein levels, suggesting the diagnosis and leading to early intravenous fluconazole therapy. Microbiological studies confirmed the diagnosis. All three patients achieved a full recovery. In conclusion, the diagnosis of maternofetal C. albicans infection rests on a suggestive history and on a constellation of clinical and laboratory test abnormalities. Complications can be prevented by initiating appropriate therapy as soon as the diagnosis is suspected, even in full-term infants.