Intra-amniotic fluconazole therapy for Candida albicans intra-amniotic infection

Obstetrics and Gynecology (Impact Factor: 4.37). 02/2013; 121(2):452-454. DOI: 10.1097/AOG.0b013e31827566ca

ABSTRACT Obstet Gynecol. 2013 Feb;121(2 Pt 2 Suppl 1):452-4. doi: http://10.1097/AOG.0b013e31827566ca.
Intra-amniotic fluconazole therapy for Candida albicans intra-amniotic infection.
Bean LM1, Jackson JR, Dobak WJ, Beiswenger TR, Thorp JA.
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The consequences of intra-amniotic Candida infection can be devastating. Currently, standard management includes delivery. We identified only one previous case reporting intrauterine antifungal therapy, which used transcervical amphotericin B. We present two cases of intra-amniotic Candida infection treated with intra-amniotic fluconazole instilled before membrane rupture.
Two patients presented with intra-amniotic Candida albicans infection that was diagnosed during previability. Both underwent cerclage placement before culture results were available. Aggressive antifungal therapy was instituted using oral, vaginal, and intra-amniotic fluconazole instilled through serial amniocenteses. Both fetuses survived without sequelae.
Intra-amniotic Candida infection is associated with preterm rupture of membranes, preterm labor, severe neonatal infection, and fetal death. Early diagnosis and treatment is essential.

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