J Korean Soc Neonatol.  1997 Jun;4(1):28-36.

Clinical Study of Neonatal Systemic Fungal Infection

Affiliations
  • 1Department of Pediatrics, Ilsin Christian Hospital, Pusan, Korea.

Abstract

PURPOSE: We evaluared the risk factors, clinical characteristic, diagnosis and treatment of neonatal systemic fungal infection in 28 cases in order to find ways to prevent development of and to improve the prognosis of neonatal systemic fungal infection
METHODS
From November 1994 to August 1996, 28 premature infants who were diagnosed as systemic fungal infection at Ilsin Christian Hospital NICU were analyzed retrospectively.
RESULTS
1) The mean gestational age was 30.7 weeks(27-35.5weeks) and the mean birth weight was 1528g(975-2980g). 2) The risk factors associated with the development of neonatal systemic fungal infection included long-term use of broad-spectrum antibiotics, prolonged hyperalimentation, prolonged use of aminophylline and steroid, and endotracheal intubation. 3) The most common presenting clinical manifestations were temperature instability, feeding intolerance, and apnea. 4) In laboratory studies, blood, urine, and CSF culture positivity was 92.8%, 92.8%, and 10.7%, respectively and renal and cranial sonogram were helpful to evaluate the renal and CNS involvement. 5) The principal treatment was intravenous amphotericin B administration for 4 weeks. The side effects, such as renal toxicity, hepatotoxicity, hypokalemia, and vomiting, developed but were reversible. 6) The mortality rate was 7.1%, and ventriculo-peritoneal shunts was performed in 3 cases who had fungal meningitis for the management of postmeningitic hydrocephalus.
CONCLUSION
For was beformedin the diagnosis of neonatal systemic fungal infection is very difficult and the mortality is high, we recommend that antifungal therapy be initiated in clinically ill infants who are not responsive to antibiotic therapy and have negative culture findings and have some of the risk factors associated with systemic fungal infection.

Keyword

Neonate; Systemic fungal infection

MeSH Terms

Aminophylline
Amphotericin B
Anti-Bacterial Agents
Apnea
Birth Weight
Diagnosis
Gestational Age
Humans
Hydrocephalus
Hypokalemia
Infant
Infant, Newborn
Infant, Premature
Intubation, Intratracheal
Meningitis, Fungal
Mortality
Prognosis
Retrospective Studies
Risk Factors
Ventriculoperitoneal Shunt
Vomiting
Aminophylline
Amphotericin B
Anti-Bacterial Agents
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