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Zygomycosis in neonates: an uncommon but life-threatening infection

Emmanuel Roilides1, Theoklis E Zaoutis, Aspasia Katragkou

  • 13rd Department of Pediatrics, Aristotle University, Thessaloniki, Greece. roilides@med.auth.gr

American Journal of Perinatology
|April 25, 2009
PubMed

Insights

Neonatal zygomycosis, a serious fungal infection in newborns, commonly affects the gastrointestinal and skin systems. Early treatment with amphotericin B and surgery improves survival rates for this high-mortality condition.

Area of Science:

  • Mycology
  • Neonatal Medicine
  • Infectious Diseases

Background:

  • Zygomycosis is a rare but severe fungal infection with high mortality.
  • Neonatal cases are increasingly recognized, presenting unique challenges.

Purpose of the Study:

  • To systematically review published cases of zygomycosis in neonates.
  • To describe the clinical patterns, diagnostic methods, and outcomes of neonatal zygomycosis.

Main Methods:

  • Systematic review of English-language publications of neonatal zygomycosis cases (0-1 month).
  • Inclusion based on prespecified criteria; data extraction on demographics, clinical presentation, diagnosis, treatment, and outcomes.
  • Literature search of PubMed and reference lists up to July 2007.

Main Results:

  • Fifty-nine cases were identified; 77% of infants were premature.
  • Gastrointestinal (54%) and cutaneous (36%) zygomycosis were most common, differing from older children.
  • Overall mortality was 64%; survival was higher with amphotericin B and surgery (70%) versus no therapy (5%).

Conclusions:

  • Neonatal zygomycosis is a life-threatening infection with distinct GI and cutaneous patterns.
  • High mortality necessitates prompt diagnosis and aggressive management.
  • Combination therapy with amphotericin B and surgery appears to improve survival outcomes.

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