FUNGAL STERNAL WOUND-INFECTION DUE TO CURVULARIA-LUNATA IN A NEONATE WITH CONGENITAL HEART-DISEASE - CASE-REPORT AND REVIEW

We describe a neonate with congenital heart disease in whom a sternal wound infection caused by the filamentous fungus Curvularia lunata dev eloped following cardiac surgery. Despite their widespread distributio n in the environment, Curvularia species rarely cause human infection. We also review the 43 cases of curvularia infection previously report ed in the English-language literature; only four of these cases occurr ed in children. A wide spectrum of infections-including keratitis, cut aneous infections, sinusitis, allergic bronchopulmonary disease, pneum onia, chronic ambulatory peritoneal dialysis-related infections, endoc arditis, and disseminated infections-have been described. Curvularia i s a pathogen that can cause disease in both immuno-competent and immun ocompromised hosts, although more severe and disseminated disease occu rs in patients with defective immune function. Surgery alone usually i s successful for treating locally invasive disease, although a combina tion of medical and surgical therapy is necessary for treating dissemi nated infections.