Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature

(1) Background: Although invasive fungal infections are a major cause of neonatal morbidity and mortality, data on the incidence and outcomes of localized abscesses in solid organs due to fungal infections are scarce. The aim of this study was to consolidate evidence and enhance our understanding on...

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Main Authors: Paschalia Kopanou Taliaka, Andreas G. Tsantes, Aikaterini Konstantinidi, Dimitra Houhoula, Konstantina A. Tsante, Aristeidis G. Vaiopoulos, Daniele Piovani, Georgios K. Nikolopoulos, Stefanos Bonovas, Nicoletta Iacovidou, Argirios E. Tsantes, Rozeta Sokou
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Life
Subjects:
Online Access:https://www.mdpi.com/2075-1729/13/1/167
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author Paschalia Kopanou Taliaka
Andreas G. Tsantes
Aikaterini Konstantinidi
Dimitra Houhoula
Konstantina A. Tsante
Aristeidis G. Vaiopoulos
Daniele Piovani
Georgios K. Nikolopoulos
Stefanos Bonovas
Nicoletta Iacovidou
Argirios E. Tsantes
Rozeta Sokou
author_facet Paschalia Kopanou Taliaka
Andreas G. Tsantes
Aikaterini Konstantinidi
Dimitra Houhoula
Konstantina A. Tsante
Aristeidis G. Vaiopoulos
Daniele Piovani
Georgios K. Nikolopoulos
Stefanos Bonovas
Nicoletta Iacovidou
Argirios E. Tsantes
Rozeta Sokou
author_sort Paschalia Kopanou Taliaka
collection DOAJ
description (1) Background: Although invasive fungal infections are a major cause of neonatal morbidity and mortality, data on the incidence and outcomes of localized abscesses in solid organs due to fungal infections are scarce. The aim of this study was to consolidate evidence and enhance our understanding on neonatal liver abscesses due to invasive fungal infections. (2) Methods: An electronic search of the PubMed and Scopus databases was conducted, considering studies that evaluated fungal liver abscesses in the neonatal population. Data on the epidemiology, clinical course, treatment, and outcome of these infections were integrated in our study. (3) Results: Overall, 10 studies were included presenting data on 19 cases of neonatal fungal liver abscesses. <i>Candida</i> spp. were the most common causative pathogens (94.7%). Premature neonates constituted the majority of cases (93%), while umbilical venous catheter placement, broad spectrum antibiotics, and prolonged parenteral nutrition administration were identified as other common predisposing factors. Diagnosis was established primarily by abdominal ultrasonography. Medical therapy with antifungal agents was the mainstay of treatment, with Amphotericin B being the most common agent (47%). Abscess drainage was required in four cases (21%). Eradication of the infection was achieved in the majority of cases (80%). (4) Conclusions: Even though fungal liver abscess is a rare entity in the neonatal population, clinicians should keep it in mind in small, premature infants who fail to respond to conventional treatment for sepsis, particularly if an indwelling catheter is in situ. A high index of suspicion is necessary in order to achieve a timely diagnosis and the initiation of the appropriate treatment.
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spelling doaj.art-3f83393fe23f4dee92cc6d297e5168012023-11-30T23:08:56ZengMDPI AGLife2075-17292023-01-0113116710.3390/life13010167Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the LiteraturePaschalia Kopanou Taliaka0Andreas G. Tsantes1Aikaterini Konstantinidi2Dimitra Houhoula3Konstantina A. Tsante4Aristeidis G. Vaiopoulos5Daniele Piovani6Georgios K. Nikolopoulos7Stefanos Bonovas8Nicoletta Iacovidou9Argirios E. Tsantes10Rozeta Sokou11Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, GreeceMicrobiology Department, “Saint Savvas” Oncology Hospital, 11522 Athens, GreeceNeonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, GreeceDepartment of Food Science and Technology, University of West Attica, 12244 Egaleo, GreeceLaboratory of Reliability and Quality Control in Laboratory Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, Egaleo, 12244 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceIRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, ItalyMedical School, University of Cyprus, Nicosia 2029, CyprusIRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, ItalyNeonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceNeonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, Greece(1) Background: Although invasive fungal infections are a major cause of neonatal morbidity and mortality, data on the incidence and outcomes of localized abscesses in solid organs due to fungal infections are scarce. The aim of this study was to consolidate evidence and enhance our understanding on neonatal liver abscesses due to invasive fungal infections. (2) Methods: An electronic search of the PubMed and Scopus databases was conducted, considering studies that evaluated fungal liver abscesses in the neonatal population. Data on the epidemiology, clinical course, treatment, and outcome of these infections were integrated in our study. (3) Results: Overall, 10 studies were included presenting data on 19 cases of neonatal fungal liver abscesses. <i>Candida</i> spp. were the most common causative pathogens (94.7%). Premature neonates constituted the majority of cases (93%), while umbilical venous catheter placement, broad spectrum antibiotics, and prolonged parenteral nutrition administration were identified as other common predisposing factors. Diagnosis was established primarily by abdominal ultrasonography. Medical therapy with antifungal agents was the mainstay of treatment, with Amphotericin B being the most common agent (47%). Abscess drainage was required in four cases (21%). Eradication of the infection was achieved in the majority of cases (80%). (4) Conclusions: Even though fungal liver abscess is a rare entity in the neonatal population, clinicians should keep it in mind in small, premature infants who fail to respond to conventional treatment for sepsis, particularly if an indwelling catheter is in situ. A high index of suspicion is necessary in order to achieve a timely diagnosis and the initiation of the appropriate treatment.https://www.mdpi.com/2075-1729/13/1/167fungal infectionliver abscessneonatescandidemiapretermantifungal therapy
spellingShingle Paschalia Kopanou Taliaka
Andreas G. Tsantes
Aikaterini Konstantinidi
Dimitra Houhoula
Konstantina A. Tsante
Aristeidis G. Vaiopoulos
Daniele Piovani
Georgios K. Nikolopoulos
Stefanos Bonovas
Nicoletta Iacovidou
Argirios E. Tsantes
Rozeta Sokou
Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature
Life
fungal infection
liver abscess
neonates
candidemia
preterm
antifungal therapy
title Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature
title_full Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature
title_fullStr Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature
title_full_unstemmed Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature
title_short Risk Factors, Diagnosis, and Treatment of Neonatal Fungal Liver Abscess: A Systematic Review of the Literature
title_sort risk factors diagnosis and treatment of neonatal fungal liver abscess a systematic review of the literature
topic fungal infection
liver abscess
neonates
candidemia
preterm
antifungal therapy
url https://www.mdpi.com/2075-1729/13/1/167
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