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Transabdominal collection of amniotic fluid 'sludge' and identification of Candida albicans intra-amniotic infection
- Source :
- The Journal of Maternal-Fetal & Neonatal Medicine. 31:1279-1284
- Publication Year :
- 2017
- Publisher :
- Informa UK Limited, 2017.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- ISSN :
- 14764954 and 14767058
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- The Journal of Maternal-Fetal & Neonatal Medicine
- Accession number :
- edsair.doi.dedup.....1ef6c9dcc5aa6f0965797477ddc30c1b