Central nervous system candidiasis in very low-birth-weight premature neonates and infants

US characteristics and histopathologic and MR imaging correlates in five patients

Chao Ching Huang, Cheng Yu Chen, Hsiao Bai Yang, Shih Min Wang, Ying Chao Chang, Ching Chuan Liu

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

PURPOSE: To analyze the high-resolution (ie, 5.0- or 7.5-MHz) ultrasonographic (US) imaging characteristics of central nervous system (CNS) candidiasis and their histopathologic and magnetic resonance (MR) imaging correlates in very low-birth-weight (VLBW) premature neonates and infants with systemic candidiasis. MATERIALS AND METHODS: The US images obtained in one VLBW neonate (age, 24 days; weight, 846 g) and four VLBW infants (age range, 36-161 days; weight range, 800-1,360 g) with proved CNS candidiasis complicating systemic candidiasis and the clinical (n = 5), histophatologic (n = 3), and MR imaging (n = 2) correlates were retrospectively reviewed. RESULTS: The cranial US findings consisted of parenchymal abnormalities in four and ventricular lesions in three patients. The most common findings were multiple echogenic, rimlike microabscesses (four patients) scattered in the subcortical, periventricular, and basal ganglial areas. Confluent macroabscess formation, seen as echogenic masslike lesions with hypoechoic centers in the periventricular regions and/or thalami, was noted on the US images obtained in two patients. The ventricles showed dilatation in two, increased ependymal echogenicity in three, the presence of intraventricular echogenic septa in two, and a lumpy choroid plexus or the presence of debris in two patients. US findings correlated well with MR imaging and autopsy findings. The histopathologic changes in the posterior fossa were well demonstrated on MR images but not demonstrated on 5.0- or 7.5-MHz US images. CONCLUSION: CNS candidiasis in VLBW neonates and infants has characteristic US features that may help in the early diagnosis of CNS involvement in systemic candidiasis.

Original languageEnglish
Pages (from-to)49-56
Number of pages8
JournalRadiology
Volume209
Issue number1
Publication statusPublished - Oct 1998
Externally publishedYes

Fingerprint

Very Low Birth Weight Infant
Candidiasis
Low Birth Weight Infant
Premature Infants
Central Nervous System
Magnetic Resonance Imaging
Newborn Infant
Weights and Measures
Choroid Plexus
Thalamus
Early Diagnosis
Dilatation
Autopsy
Magnetic Resonance Spectroscopy
Systemic candidiasis

Keywords

  • Central nervous system, infection
  • Infants, newborn, central nervous system
  • Magnetic resonance (MR), in infants and children
  • Ultrasound (US), in infants and children

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Central nervous system candidiasis in very low-birth-weight premature neonates and infants : US characteristics and histopathologic and MR imaging correlates in five patients. / Huang, Chao Ching; Chen, Cheng Yu; Yang, Hsiao Bai; Wang, Shih Min; Chang, Ying Chao; Liu, Ching Chuan.

In: Radiology, Vol. 209, No. 1, 10.1998, p. 49-56.

Research output: Contribution to journalArticle

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AB - PURPOSE: To analyze the high-resolution (ie, 5.0- or 7.5-MHz) ultrasonographic (US) imaging characteristics of central nervous system (CNS) candidiasis and their histopathologic and magnetic resonance (MR) imaging correlates in very low-birth-weight (VLBW) premature neonates and infants with systemic candidiasis. MATERIALS AND METHODS: The US images obtained in one VLBW neonate (age, 24 days; weight, 846 g) and four VLBW infants (age range, 36-161 days; weight range, 800-1,360 g) with proved CNS candidiasis complicating systemic candidiasis and the clinical (n = 5), histophatologic (n = 3), and MR imaging (n = 2) correlates were retrospectively reviewed. RESULTS: The cranial US findings consisted of parenchymal abnormalities in four and ventricular lesions in three patients. The most common findings were multiple echogenic, rimlike microabscesses (four patients) scattered in the subcortical, periventricular, and basal ganglial areas. Confluent macroabscess formation, seen as echogenic masslike lesions with hypoechoic centers in the periventricular regions and/or thalami, was noted on the US images obtained in two patients. The ventricles showed dilatation in two, increased ependymal echogenicity in three, the presence of intraventricular echogenic septa in two, and a lumpy choroid plexus or the presence of debris in two patients. US findings correlated well with MR imaging and autopsy findings. The histopathologic changes in the posterior fossa were well demonstrated on MR images but not demonstrated on 5.0- or 7.5-MHz US images. CONCLUSION: CNS candidiasis in VLBW neonates and infants has characteristic US features that may help in the early diagnosis of CNS involvement in systemic candidiasis.

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