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August 1997

Radiological Case of the Month

Author Affiliations

From the Division of Neonatology, William Beaumont Hospital, Royal Oak, Mich.

Arch Pediatr Adolesc Med. 1997;151(8):845-846. doi:10.1001/archpedi.1997.02170450095016

A NEONATE weighing 739 g was delivered by cesarean section as the second of triplets at 253/7 weeks of gestation. The neonate was empirically treated with ampicillin sodium and gentamicin sulfate for 7 days, with the discontinuance of medication followed by clinical deterioration, which led to the institution of 2 separate 3-day treatment courses of vancomycin and cefotaxime sodium. At 11 days of age, dexamethasone treatment was started for severe lung disease. Blood, urine, and cerebrospinal fluid cultures obtained at 4 weeks grew Candida albicans and antifungal treatment with amphotericin B and oral flucytosine was started. Echocardiogram, renal ultrasonogram, cranial ultrasonogram, and eye evaluation results were normal at this time. One week after the antifungal treatment was started, a cranial ultrasonogram study showed left periventricular hyperechoic regions and mild ventricular dilation. The cerebrospinal fluid from lumbar puncture was negative for C albicans but showed a protein level of 2.38 g/L.

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