Aspergillosis in neonates and infants at or below 3 months of age
Andreas H. Groll and Rolf L.Schloesser
Date: 1 May 1999
As of the end of 1998, 49 cases of proven (cultural and histological evidence) or probable (histological or cultural evidence) invasive aspergillosis have been reported in neonates and infants = three months of age [Groll et al., 1998; Meessen et al., 1998; Singer et al., 1998]. Most patients had primary cutaneous aspergillosis (n=16), invasive pulmonary aspergillosis (n=10), or disseminated aspergillosis (n=14). Prematurity, chronic granulomatous disease, and a complex of diarrhoea, dehydration, malnutrition and invasive bacterial infections accounted for the majority of underlying conditions. Routes of infection, clinical symptoms, fungal isolates and patterns of disease were similar to those observed in pediatric [Walmsley et al., 1993] and adult [Bodey & Vartivarian, 1989; Denning, 1996] populations. Only one of the reported infants had been neutropenic prior to diagnosis, but at least half had been given corticosteroids in pharmacological doses prior to diagnosis. Almost all cases of primary cutaneous aspergillosis occurred in extremely premature neonates; pulmonary and disseminated infection mainly occurred in term neonates. The disease was uniformly fatal in untreated patients. In contrast, outcome was relatively favorable in patients receiving appropriate systemic antifungal and/or surgical therapy [Groll et al., 1998; Singer et al., 1998].
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