Macrophage activation syndrome triggered by Candida parapsilosis-related cochlear implant infection
European Archives of Oto-Rhino-Laryngology, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00405-026-10374-x
- Dergi Adı: European Archives of Oto-Rhino-Laryngology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: Cochlear implant, Macrophage activation syndrome, Candida parapsilosis, Pediatric, Biofilm infection, Hemophagocytic lymphohistiocytosis, Implant-related infection, Explantation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Cochlear implant-related infections may rarely lead to life-threatening systemic complications. Macrophage Activation Syndrome (MAS) is a severe and potentially fatal hyperinflammatory condition. MAS associated with CI infection has not been previously reported in pediatric patients. Case presentation: We present a 13-year-old female patient who developed MAS secondary to Candida parapsilosis-related sepsis associated with cochlear implant (CI). Despite broad-spectrum antibacterial and antifungal therapy, the patient’s clinical course deteriorated with pancytopenia, hyperferritinemia, and acute liver failure. She fulfilled HLH-2004 criteria and was diagnosed with MAS. Multidisciplinary treatment approach included plasmapheresis, high-dose pulse corticosteroids and CI explantation, resulted in clinical recovery. Implant site cultures revealed that Candida parapsilosis, a fungal pathogen known for biofilm formation and implant-related infections. Following explantation, the patient showed gradual improvement with immunosuppressive therapy and supportive care. Successful cochlear implant reimplantation was performed two months later. Conclusion: CI-related infections and related systemic complications are rare but severe. This is the first reported pediatric case of MAS triggered by cochlear implant-related sepsis. Early recognition of MAS and multidisciplinary management are essential to improve outcome and survival.