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 severe ly ill neonate and review 43 additional cases of invasive aspergillosi s reported from 1955 through 1996 that occurred during the first 3 mon ths of life. Eleven of the 44 patients had primary cutaneous aspergill osis, 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 diarrhe a, dehydration, malnutrition, and invasive bacterial infections (23%) accounted for the majority of underlying conditions. At least 41% of t he patients had received corticosteroid therapy before diagnosis, but only one patient had been neutropenic. Among patients who received med ical 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 ci rcumstances. Current therapeutic approaches consist of high-dose ampho tericin B and appropriate surgical interventions.