{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T22:09:04Z","timestamp":1766268544202,"version":"3.28.0"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Introduction Bacteria are the most common pathogens implicated in ascending infections in patients with cervical insufficiency. However, Candida albicans is a rare and serious cause of intra-amniotic infection that should be considered on the differential diagnosis. Upon diagnosis following cerclage placement, patients are generally advised to undergo immediate cerclage removal and discontinuation of the pregnancy due to the high risk of maternal and fetal morbidity. However, some patients decline and instead elect to continue the pregnancy with or without treatment. Limited data exist to guide management of these high-risk patients.<\/jats:p><jats:p>\n            Case Presentation\u2003We describe a case of previable intra-amniotic C. albicans infection diagnosed following physical examination\u2013indicated cerclage placement. The patient declined pregnancy termination and subsequently underwent systemic antifungal therapy as well as serial intra-amniotic fluconazole instillations. Fetal blood sampling confirmed transplacental transfer of maternal systemic antifungal therapy. The fetus delivered preterm and without evidence of fungemia, despite persistently positive amniotic fluid cultures.<\/jats:p><jats:p>\n            Conclusion\u2003In a well-counseled patient with culture-proven intra-amniotic C. albicans infection declining termination of pregnancy, multimodal antifungal therapy in the form of systemic and intra-amniotic fluconazole administration may prevent subsequent fetal or neonatal fungemia and improve postnatal outcomes.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2051-2353","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:24:45Z","timestamp":1678407885000},"page":"e1463-e1469","source":"Crossref","is-referenced-by-count":2,"special_numbering":"S","title":["Multimodal Management of Cervical Insufficiency Complicated by Intra-amniotic Candida albicans Infection"],"prefix":"10.1055","volume":"41","author":[{"given":"Andrew H.","family":"Chon","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California"},{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha A.","family":"Monson","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California"},{"name":"Department of Obstetrics and Gynecology, Intermountain Healthcare, Salt Lake City, Utah"},{"name":"Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole G.","family":"Gomez","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan M.","family":"Butler-Wu","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, Los Angeles County-University of Southern California Medical Center, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramen H.","family":"Chmait","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/01.AOG.0000443276.68274.cc","article-title":"ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency","volume":"123","author":"American College of Obstetricians Gynecologists","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/GRF.0000000000000184","article-title":"Overview of cervical insufficiency: diagnosis, etiologies, and risk factors","volume":"59","author":"A Roman","year":"2016","journal-title":"Clin Obstet Gynecol"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1515\/jpm-2020-0255","article-title":"Cervical insufficiency: a noteworthy disease with controversies","volume":"48","author":"Y 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