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Disseminated Bipolaris spicifera in a neonate
M L Moore1, G R Collins, B J Hawk
1Department of Pediatrics, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA.
Summary
A premature infant developed a severe fungal infection caused by Bipolaris spicifera. Despite treatment, the infection disseminated throughout the body, highlighting a rare neonatal case.
Area of Science:
- Neonatal Medicine
- Mycology
- Infectious Diseases
Background:
- Premature infants, especially those born extremely preterm, are highly susceptible to infections due to immature immune systems.
- Disseminated fungal infections pose a significant threat to neonates, often leading to high morbidity and mortality.
- Bipolaris species are increasingly recognized as opportunistic human pathogens, particularly in immunocompromised individuals.
Observation:
- A neonate born at 23 4/7 weeks gestation developed erythematous skin lesions at 7 days of life (DOL).
- These lesions rapidly progressed to black, necrotic skin manifestations.
- Shave biopsy confirmed invasive fungal organisms identified as Bipolaris spicifera.
Findings:
- The disseminated fungal infection persisted despite aggressive surgical debridement and broad-spectrum antifungal therapy.
- Autopsy revealed Bipolaris spicifera throughout multiple internal organs, confirming systemic dissemination.
- This case represents the first documented instance of Bipolaris spicifera infection in a neonate.
Implications:
- This case underscores the need for heightened awareness of Bipolaris spicifera as a potential neonatal pathogen.
- Early recognition and diagnosis are critical for managing invasive fungal infections in extremely preterm infants.
- Further research into the pathogenesis and treatment of Bipolaris infections in neonates is warranted.