Candida glabrata infection of the amniotic fluid with chorioamnionitis and maternal candidemia and a negative 1,3-β-D-glucan test: A case report

Abstract

A case is reported of Candida glabrata microbial invasion of the amniotic cavity and maternal candidemia with a negative 1,3-β-D-glucan test. A 28-year-old singleton pregnant woman (gravida 1, para 0) presented at 18 weeks and 3 days of gestation following in vitro fertilization and embryo transfer. She had suddenly experienced uterine contraction and genital bleeding with watery discharge and. After diagnosing preterm rupture of the membrane with clinical chorioamnionitis, Candida glabrata was detected both in the amniotic fluid and in the vaginal discharge; however, a test for 1,3-β-D-glucan in the maternal serum was negative. At 18 weeks and 5 days of gestation, the pregnancy was terminated after intensive counseling. On the eighth day of admission, Candida glabrata was detected in maternal blood culture. When a culture of amniotic fluid is positive for Candida glabrata, even if the 1,3-β-D-glucan test is negative, maternal candidemia should be suspected in the presence of features of clinical chorioamnionitis.

Keywords: 1,3-β-D-glucan; Candidemia; Chorioamnionitis.

Fig. 1

Histopathological picture showing chorion in the placenta. (a) Neutrophilic infiltration in the chorion (hematoxylin and eosin stain). (b) Spores, suggested as Candida spp., detected by Grocott-Gomori Methenamine Silver stain.