What are Neonatal Fungal Infections?
Neonatal fungal infections are infections caused by fungi that occur in newborns, particularly those born prematurely or with low birth weight. These infections can lead to significant morbidity and mortality, especially in
neonates with compromised immune systems.
Prematurity and low birth weight
Prolonged antibiotic use
Use of central venous catheters
Parenteral nutrition
Immune suppression
Mechanical ventilation
Mucocutaneous Candidiasis: White patches on the tongue, inside the mouth, and diaper area.
Systemic Candidiasis: Poor feeding, lethargy, respiratory distress, and signs of sepsis.
Disseminated Candidiasis: Multiple organ involvement, including liver, spleen, kidneys, and eyes.
Blood cultures
Urine cultures
CSF analysis
Imaging studies such as ultrasounds or MRIs
Tissue biopsies in severe cases
What are the Treatment Options?
Treatment generally involves antifungal medications. The choice of drug depends on the type of fungus and the severity of the infection:
Fluconazole is commonly used for prophylaxis and treatment.
Amphotericin B is often used for systemic infections but has significant toxicity.
Echinocandins like caspofungin and micafungin are newer options with fewer side effects.
Minimizing the use of broad-spectrum antibiotics
Strict adherence to sterile techniques during invasive procedures
Limiting the duration of central venous catheter use
Regular surveillance cultures in high-risk neonates
Prophylactic antifungal treatment in extremely low birth weight infants
Superficial infections like oral thrush generally have a good prognosis with appropriate treatment.
Systemic and disseminated infections carry a higher risk of complications and mortality, particularly in very low birth weight infants.
Early diagnosis and prompt treatment are crucial for improving outcomes.
