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Infective endocarditis is rare in children, it is rarer after a surgical treatment of atrioventricular canal, and it is exceptional that Candida albicans is the etiologic agent. This is a serious infection found in congenital heart disease with or without surgery. It is potentially lethal, despite diagnostic and therapeutic advances. We report a case of infective endocarditis due to C. albicans after the treatment of a congenital systemic atrioventricular canal in a child with trisomy 21. The diagnosis was suspected on clinical manifestations and cardiac auscultation. Confirmation was provided by positive blood cultures and echocardiography. The large size of the vegetation in the patient was in favor of a fungal etiology, blood cultures allowed to identify the fungus. This observation illustrates a poorly understood disease, with very poor prognosis and which is a potential complication of heart surgery. The improved prognosis should be achieved by shortening the time to diagnosis and optimizing the therapeutic support., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: Description of the epidemiological and clinical characteristics of the patients introducing risk factors of invasive candidiasis. Analysis of risk factors for candidiasis invasive and evaluation of the contribution of colonization index (CI) in the diagnosis of the systematic candidiasis in medical intensive care., Patients and Methods: Prospective observational study (October 2007 to October 2009). The selected patients present risk factors of system IC candidiasis with an infectious syndrome or clinical signs suggestive of Candida infection and hospitalized more than 48 hours in medical intensive care unit. Pittet's colonization index was calculated at admission and then once a week added to a blood culture. Patients were classified according to level of evidence of Candida infection and the degree of colonization (CI<0.5, CI ≥ 0.5)., Results: The study included 100 patients. Mean age of our patients was 55.8 ± 18.2 years with male prevalence. Neurological disease was the most frequent pathology in admission (48%). The most common risk factors were broad-spectrum antibiotics and foreign material. In the various mycology IC specimens, Candida albicans was the most frequent, followed by C. tropicalis, then C. glabrata. The CI was greater than or equal to 0.5 at 53% of the patients, and less than 0.5 in 47% of the cases. Among the patients, 15% developed an invasive candidiasis. In multivariate analysis, the corticosteroid therapy was associated with a high colonisation (IC ≥ 0.5) and neutropenia with a high risk of systemic candidiasis. The positive predictive value of CI was 26%. The negative predictive value was 98%, the sensitivity and specificity was 93% and 48% respectively., Conclusion: CI has the advantage to provide a quantified data of the patient's situation in relation to the colonization. But, it isn't helpful with patients having an invasive candidiasis in medical intensive care unit., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Aspergillus fumigatus is a resistant filamentous fungus, common in the environment and pathogenic for human. The most common sites of primary aspergillosis are the maxillary sinus and lungs. Intracranial location is rare and may develop after hematogenous dissemination or contiguity. The invasive pseudotumoral form usually concerns immunodepressed patients. Invasive aspergillosis of the cavum is rare and its diagnosis is difficult. This infection can be fatal because of endocranial involvement and permeabilization of the blood-brain barrier, facilitating other neuromeningeal mycotic infections. We report the case of a 70-year-old diabetic and hypertensive female patient having presented with an invasive aspergillosis of the cavum and endocranial involvement complicated by Candida meningitis.

The aim of this article is to report a case of congenital cutaneous candidiasis (CCC). We describe the clinical features and emphasize the role of laboratory testings to assess diagnosis in the newborn and to prevent this condition by screening vaginal candidiasis in pregnant women. A full-term, 3500-g male was born by spontaneous vaginal delivery to a 30-year-old healthy woman. On physical examination, he was a well-developed, vigorous newborn. Since the first hours of his life he presented erythematous maculae diffusely distributed on the skin and pustules overlying areas of confluent macular erythema on his trunk and extremities. The palms and soles were not affected. Neither oral thrush nor peri-anal lesions have been observed. The rest of the physical examination was normal. Microscopic examination of skin scrapings showed the presence of many yeasts and the culture permitted the identification of a strain of Candida albicans. Precocity and extent of the cutaneous signs attest a congenital cutaneous candidiasis and eliminate the other skin diseases of similar clinical symptoms. Topical antifungal therapy (econazole) was given and the cutaneous lesions disappeared after 20 days. CCC appears to be acquired in utero by the ascension of organisms from an infected vagina into the uterine cavity. This condition is preventable with systematic screening and treatment of vulvo-vaginitis due to Candida albicans in pregnant women, The important role played by the laboratory of mycology remains essential.

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Introduction: La mucormycose occupe la troisième place parmi les infections fongiques profondes opportunistes après la candidose et l’aspergillose. C’est une infection fongique rare en pédiatrie, mais souvent fatale, qui survient chez des sujets immunodéprimés. Observation: Lina âgée de 23 mois, hospitalisée pour prise en charge d’un syndrome d’activation macrophagique d’allure idiopathique évoluant depuis 2 mois. Un traitement à base d’antibiothérapie à large spectre et une corticothérapie par Méthylprednisolone a été instauré. Un mois plus tard, la patiente développe des lésions nécrotiques au niveau du nez et en regard du sinus maxillaire droit. La TDM du massif facial a objectivée une sinusite ethmoido-maxillaire bilatérale. L’examen mycologique d’un prélèvement nasal a mis en évidence la présence de filaments mycéliens non cloisonnée, la culture sur milieu Sabouraud a isolé Absidia corymbifera. Un traitement par amphotéricine B est instauré mais mal toléré. L’évolution est rapidement défavorable aboutissant au décès. Conclusion: Cette observation rappelle les principales caractéristiques cliniques, radiologiques et mycologiques de cette infection potentiellement gravissime sur un terrain d’immunodepression. [ABSTRACT FROM AUTHOR]