Systemic candidiasis is notoriously difficult to diagnose in neonates;
however, it is frequently described and has a high mortality and morb
idity. It is particularly likely to occur in extremely low birthweight
babies, especially those receiving long-term parenteral nutrition and
antibiotics. The clinical features are non-specific. Thrombocytopenia
occurs in almost all cases of systemic candidiasis, but also in about
half the cases of bacterial sepsis. Empirical antifungal therapy shou
ld be considered mote readily for high-risk, clinically septic, thromb
ocytopenic babies.