Invasive pulmonary aspergillosis in a critically ill neonate: case report and review of invasive aspergillosis during the first 3 months of life.
We report a fatal case of invasive pulmonary aspergillosis in a severely ill neonate and review 43 additional cases of invasive aspergillosis reported from 1955 through 1996 that occurred during the first 3 months of life. Eleven of the 44 patients had primary cutaneous aspergillosis, 10 had invasive pulmonary aspergillosis, and 14 had disseminated disease. Most infections were nosocomial in origin. Prematurity (43%); proven chronic granulomatous disease (14%); and a complex of diarrhea, dehydration, malnutrition, and invasive bacterial infections (23%) accounted for the majority of underlying conditions. At least 41% of the patients had received corticosteroid therapy before diagnosis, but only one patient had been neutropenic. Among patients who received medical and/or surgical treatment, outcome was relatively favorable, with an overall survival rate of 73%. Invasive aspergillosis may occur in neonates and young infants and warrants consideration under certain circumstances. Current therapeutic approaches consist of high-dose amphotericin B and appropriate surgical interventions.
Department of Pediatrics, Johann Wolfgang Goethe University Hospital, Frankfurt/Main, Germany.
A H
AH
Groll
G
G
Jaeger
A
A
Allendorf
G
G
Herrmann
R
R
Schloesser
V
V
von Loewenich
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology* / Q000635:transmission; D001230:Aspergillus / Q000302:isolation & purification; D002493:Central Nervous System Diseases / Q000209:etiology; D016638:Critical Illness; D003428:Cross Infection / Q000382:microbiology; D003881:Dermatomycoses / Q000209:etiology; D017809:Fatal Outcome; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology; D008297:Male
D000935:Antifungal Agents; D000666:Amphotericin B