We report the case of a preterm newborn with 24 weeks of gestational age and birth weight of 685 g.
Controlled twin pregnancy by in vitro fertilization.
After vaginal delivery with ceftazidime and fetal distress (Apgar 4-6), she was intubated in the delivery room.
She was admitted to the intensive care unit with mechanical ventilation.
She remained on parenteral nutrition and central venous catheter for the first day and required administration of exogenous pulmonary surfactant with poor response.
Blood and urine samples were obtained at admission and empirical treatment of early neonatal sepsis (ampi-cillin and gentamicin) was initiated.
After five days of antimicrobial treatment she presented clinical worsening and alteration of laboratory tests so the antibiotic therapy was changed to cover nosocomial sepsis (vancomycin and ceftazidime) and new urine samples were obtained for culture.
One week after birth, the umbilical artery catheter was removed and vancomycin-sensitive Staphylococcus epidermidis was isolated.
Ceftazidime was discontinued and vancomycin was maintained for another 10 days.
Cultures performed (blood, urine and CSF) were negative.
Per sequels, malformations and respiratory diseases tend to worsen progressively until death at 20 days of life.
After death, the catheters (central venous and arterial) and the endotracheal tube were grown in thioglycolate enrichment broth and chocolate agar.
In all of them, at 24 hours of immobilization was observed at 37 °C, pure culture, dry colonies of cream color and rough surface were obtained Down at 30 °C and agarastk was later acquired as agartek.
Parallel to this, a direct view was performed on the fans in which hyphae were observed with intercautery and terminal ramified arthroconidia.
Finally, urease positivity was confirmed as a differential diagnosis with Geotrichum sp.
Susceptibility testing was performed with a booster dose of fluconazole for YeastOne Y 07 (Trek Diagnostic Systems®) and for amphotericin 5 μg CIM 0.25 μg itraconazole
In the cultures of the other twin, who was also admitted to the Neonatal Intensive Care Unit, no pathogen of interest was isolated, with a good clinical evolution in his hospital stay.
