{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:10:53Z","timestamp":1760235053491,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T00:00:00Z","timestamp":1626134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University Research Grant","award":["GUP-2020-206"],"award-info":[{"award-number":["GUP-2020-206"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background:Candida chorioamnionitis is rarely encountered, even though vulvovaginal candidiasis incidence is about 15%. Interestingly, it has characteristic gross and histological findings on the umbilical cord that are not to be missed. Case Report: We report two cases of Candida chorioamnionitis with presence of multiple yellowish and red spots of the surface of the umbilical cord. Microscopically, these consist of microabscesses with evidence of fungal yeasts and pseudohyphae. The yeasts and pseudohyphae were highlighted by periodic acid\u2013 Schiff and Grocott methenamine silver histochemical stains. Both cases were associated with a history of gestational diabetes mellitus. Discussion: Peripheral funisitis is a characteristic feature of Candida chorioamnionitis. It is associated with high risk of adverse perinatal and neonatal outcomes, such as preterm delivery, stillbirth and neonatal death. We recommend careful examination of the umbilical cord of mothers with gestational diabetes mellitus.<\/jats:p>","DOI":"10.3390\/ijerph18147450","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T04:26:06Z","timestamp":1626150366000},"page":"7450","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Candida Chorioamnionitis in Mothers with Gestational Diabetes Mellitus: A Report of Two Cases"],"prefix":"10.3390","volume":"18","author":[{"given":"Elia","family":"Shazniza Shaaya","sequence":"first","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siti Atiqah Abdul","family":"Halim","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ka Wen","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8901-4614","authenticated-orcid":false,"given":"Kevin Boon Ping","family":"Ku","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei Shan","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2289-7619","authenticated-orcid":false,"given":"Geok Chin","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4897-9927","authenticated-orcid":false,"given":"Yin Ping","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/0002-9378(58)90572-6","article-title":"Candida albicans infection of the amniotic sac","volume":"75","author":"Benirschke","year":"1958","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1007\/s100249900014","article-title":"Candida funisitis: A clinicopathologic study of 32 cases","volume":"1","author":"Qureshi","year":"1998","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_3","first-page":"267","article-title":"Gardnerella vaginalis in perinatology: An overview of the clinicopathological correlation","volume":"40","author":"Wong","year":"2018","journal-title":"Malays. J. Pathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20201766","DOI":"10.1042\/BSR20201766","article-title":"Vaginal microbiome analysis of healthy women during different periods of gestation","volume":"40","author":"Li","year":"2020","journal-title":"Biosci. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Rodrigues, C.F., Rodrigues, M.E., and Henriques, M. (2019). Candida sp. Infections in Patients with Diabetes Mellitus. J. Clin. Med., 8.","DOI":"10.3390\/jcm8010076"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"D\u2019Enfert, C., Kaune, A.-K., Alaban, L.-R., Chakraborty, S., Cole, N., Delavy, M., Kosmala, D., Marsaux, B., Fr\u00f3is-Martins, R., and Morelli, M. (2021). The impact of the Fungus-Host-Microbiota interplay upon Candida albicans infections: Current knowledge and new perspectives. FEMS Microbiol. Rev., 45.","DOI":"10.1093\/femsre\/fuaa060"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1128\/EC.5.1.180-191.2006","article-title":"Cellular and Molecular Biology of Candida albicans Estrogen Response","volume":"5","author":"Cheng","year":"2006","journal-title":"Eukaryot. Cell"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Roberts, C.L., Rickard, K., Kotsiou, G., and Morris, J.M. (2011). Treatment of asymptomatic vaginal candidiasis in pregnancy to prevent preterm birth: An open-label pilot randomized controlled trial. BMC Pregnancy Childbirth, 11.","DOI":"10.1186\/1471-2393-11-18"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2017\/9060138","article-title":"Candida Chorioamnionitis Leads to Preterm Birth and Adverse Fetal-Neonatal Outcome","volume":"2017","author":"Maki","year":"2017","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/ped.12259","article-title":"Neonatal leukemoid reaction associated with Candida albicans chorioamnionitis","volume":"56","author":"Iwatani","year":"2014","journal-title":"Pediatr. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1111\/j.1447-0756.2012.01938.x","article-title":"Premature delivery due to intrauterine Candida infection that caused neonatal congenital cutaneous candidiasis: A case report","volume":"39","author":"Ito","year":"2012","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1159\/000431221","article-title":"Candida glabrata chorioamnionitis following in vitro Fertilization: Review of the literature","volume":"80","author":"Bar","year":"2015","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e00239","DOI":"10.1016\/j.crwh.2020.e00239","article-title":"Candida chorioamnionitis associated with late stillbirth: A case report","volume":"27","author":"Obermair","year":"2020","journal-title":"Case Rep. Women\u2019s Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s00404-010-1677-9","article-title":"Chorioamnionitis and neonatal sepsis due to Candida tropicalis","volume":"283","author":"Canpolat","year":"2010","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_15","first-page":"354","article-title":"Candida albicans chorioamnionitis associated with preterm labor and sudden intrauterine demise of one twin. A case report","volume":"45","author":"Bender","year":"2000","journal-title":"J. Reprod. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e11891","DOI":"10.1097\/MD.0000000000011891","article-title":"Association of gestational diabetes mellitus and abnormal vaginal flora with adverse pregnancy outcomes","volume":"97","author":"Zhang","year":"2018","journal-title":"Medicine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1111\/j.0001-6349.2004.0361.x","article-title":"Prevalence of fungi in the vagina, rectum and oral cavity in pregnant diabetic women: Relation to gestational age and symptoms","volume":"83","author":"Nowakowska","year":"2004","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1053\/jinf.2000.0723","article-title":"Species-specific Prevalence of Vaginal Candidiasis Among Patients with Diabetes Mellitus and its Relation to their Glycaemic Status","volume":"41","author":"Goswami","year":"2000","journal-title":"J. Infect."},{"key":"ref_19","first-page":"e13407","article-title":"The interplay between sugar and yeast infections: Do diabetics have a greater predisposition to develop oral and vulvovaginal candidiasis?","volume":"13","author":"Mohammed","year":"2021","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1080\/01443615.2017.1343810","article-title":"High glucose-mediated overex-pression of ICAM-1 in human vaginal epithelial cells increases adhesion of Candida albicans","volume":"38","author":"Mikamo","year":"2018","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"77","DOI":"10.5146\/tjpath.2013.01154","article-title":"Intrauterine fetal loss associated with Candida glabrata chorioamnionitis: Report of two cases","volume":"29","year":"2013","journal-title":"Turk. J. Pathol."},{"key":"ref_22","first-page":"365","article-title":"Multiple umbilical cord strictures in a case of intrauterine foetal demise","volume":"41","author":"Chew","year":"2019","journal-title":"Malays. J. Pathol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/S0046-8177(83)80178-6","article-title":"The inflammatory response in candidal chorioamnionitis","volume":"14","author":"Hood","year":"1983","journal-title":"Hum. Pathol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s10024-003-7070-y","article-title":"Society for Pediatric Pathology, Perinatal Sec-tion, Amniotic Fluid Infection Nosology Committee. Amniotic infection syndrome: Nosology and reproducibility of placental reaction patterns","volume":"6","author":"Redline","year":"2003","journal-title":"Pediatr. Dev. Pathol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/14\/7450\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:29:37Z","timestamp":1760164177000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/14\/7450"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,13]]},"references-count":24,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["ijerph18147450"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18147450","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2021,7,13]]}}}