Akademik Veri Yönetim Sistemi
Neurological Disorders in Newborns, NOVA Publications , ss.275-302, 2025
In neonates, disseminated fungal infections can lead to meningitis, frequently accompanied by microabscesses. The clinical presentation often resembles that of bacterial sepsis, and bacterial meningitis and brain abscesses. Neuropathological findings are also similar. While various fungi, such as Cryptococcus, Coccidioides, and Aspergillus, have been implicated in causing meningitis, abscesses, or both in newborns, Candida remains the most prevalent cause of neonatal disseminated fungal infections. The immature immune system of newborns, particularly preterm infants, coupled with factors such as invasive medical interventions (e.g., central lines, parenteral nutrition), predisposes this vulnerable population to fungal invasions of the central nervous system. Diagnosis is often delayed due to the non-specific clinical presentation, which can range from irritability, lethargy, and feeding difficulties to seizures. Radiological imaging and cerebrospinal fluid analysis are key diagnostic tools. Isolating the pathogen can be challenging. Early detection and intervention with antifungal therapy are crucial for improving outcomes. However, optimal therapeutic approaches remain an area of ongoing research, as treatment must balance efficacy with the neonate's delicate physiology. This chapter aims to provide a comprehensive review of the pathogenesis, diagnostic strategies, and current therapeutic modalities for central nervous system infections in neonates. By exploring the underlying immunological vulnerabilities and the clinical spectrum of these infections, we aim to enhance early recognition and management, ultimately improving the prognosis for affected neonates.