Transabdominal collection of amniotic fluid 'sludge' and identification of Candida albicans intra-amniotic infection
| Autor: | Paula Vargas, Roberto Romero, Eli Maymon, Rafael Valdés, Juan Pedro Kusanovic, Patricio Le Cerf, Karla Silva, Carolina Martinovic, María Elena Nilo, Offer Erez, Francisco Díaz, Víctor Córdova, Fernando Ferrer |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Antifungal Agents Amniotic fluid Hyphae Gestational Age Cervix Uteri Chorioamnionitis Ultrasonography Prenatal Article law.invention Gross examination 03 medical and health sciences Obstetric Labor Premature 0302 clinical medicine Pregnancy law Funisitis Candida albicans Humans Medicine Vaginal bleeding 030212 general & internal medicine Pregnancy Complications Infectious Fetal Death Fluconazole 030219 obstetrics & reproductive medicine biology medicine.diagnostic_test business.industry Obstetrics Candidiasis Obstetrics and Gynecology Amniotic Fluid biology.organism_classification medicine.disease Gram staining Pediatrics Perinatology and Child Health Amniocentesis Female medicine.symptom business Intrauterine Devices |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 31:1279-1284 |
| ISSN: | 1476-4954 1476-7058 |
| DOI: | 10.1080/14767058.2017.1315095 |
| Popis: | A G3P2 patient who conceived while using an intrauterine contraceptive device (IUD) presented at 20 weeks of gestation with mild irregular uterine contractions and vaginal bleeding. Sonographic examination at admission showed the presence of dense amniotic fluid "sludge" and a long sonographic uterine cervix (42 mm). To assess the microbiologic significance of amniotic fluid "sludge", we performed a transabdominal amniocentesis. The procedure was performed under real-time ultrasound, and fluid resembling pus at gross examination was noted. Rapid amniotic fluid analysis showed the presence of a high white blood cell count and structures resembling hyphae. Amniotic fluid cultures were positive for Candida albicans. Treatment was begun with broad-spectrum antibiotics, including Fluconazole, upon the visualization of pus in the "sludge" material because of the presence of hyphae in the Gram stain. Despite treatment, the patient went into spontaneous preterm labor and delivered five days after admission. Placental examination revealed acute fungal histologic chorioamnionitis and funisitis. This represents the first report of transabdominal collection and analysis of amniotic fluid "sludge" and the microbiologic detection of Candida albicans in this material. This report provides evidence that transabdominal retrieval of "sludge" is possible and may be of significant value for patient management and selection of antimicrobial agents. |
| Databáze: | OpenAIRE |
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