Neonatal Endocarditis Caused by Candida Albicans: An Infrequent Outcome Following Perinatal Asphyxia and Sepsis

Abstract

Introduction: Neonatal fungal endocarditis is valvular or mural inflammation of the endocardium caused by fungi in infants under 28 days of age; it is an uncommon condition with a severe course and high mortality. The highest-risk groups for endocarditis are patients with a gestational age of less than 29 weeks, a birth weight of less than 1,000 grams, high-flow congenital heart disease, abdominal or thoracic surgery, and those who have had intravascular catheters for prolonged periods, with the latter being thee most common in nenonates. Case Report: We present the case of a full-term newborn with a history of severe perinatal asphyxia and grade III hypoxic-ischemic encephalopathy (Sarnat III), who developed late-onset neonatal sepsis complicated by Candida Albicans endocarditis. The diagnosis was established by positive blood cultures for Candida albicans and echocardiography, which revealed intracardiac vegetation in the right atrium. Antifungal treatment with liposomal amphotericin B and fluconazole was initiated. Discusion: This case highlights the importance of timely diagnosis, close monitoring, and a multidisciplinary approach in neonates with persistent fungemia.