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Infecting Mice with Malassezia spp. to Study the Fungus-Host Interaction
06:19

Infecting Mice with Malassezia spp. to Study the Fungus-Host Interaction

Published on: November 6, 2019

Malassezia furfur--disseminated infection in premature infants

Y H Shek1, M C Tucker, A L Viciana

  • 1Department of Pathology, Georgetown University School of Medicine, Washington, D.C. 20007.

American Journal of Clinical Pathology
|November 1, 1989
PubMed

Insights

Premature infants receiving lipid emulsions via deep-line catheters developed fatal Malassezia furfur infections. Autopsies revealed widespread organ involvement, including lungs, liver, kidneys, and brain, highlighting a critical risk in neonatal intensive care.

Area of Science:

  • Medical Mycology
  • Neonatal Pathology
  • Infectious Diseases

Background:

  • Premature infants often require intensive nutritional support, including lipid emulsions delivered via central venous catheters.
  • Catheter-associated bloodstream infections are a significant concern in neonatal intensive care units.
  • Malassezia furfur is a lipophilic yeast that can cause systemic infections, particularly in vulnerable neonates.

Observation:

  • Three premature infants experienced prolonged clinical illnesses (60-67 days) culminating in death.
  • Autopsies revealed disseminated Malassezia furfur infections with massive pulmonary involvement.
  • Histopathological examination showed M. furfur in lungs, heart (endocardial vegetations), liver, kidneys, spleen, adrenal glands, pancreas, and colon.

Findings:

  • Malassezia furfur caused systemic infections with widespread organ damage, including acute inflammatory lesions like consolidation, vasculitis, septic thrombosis, and infarction.
  • Yeast cells were observed within the lumina of small vessels in distant organs, causing obstruction without vasculitis.
  • One infant developed severe meningoencephalitis due to M. furfur, indicating central nervous system involvement.

Implications:

  • Lipid emulsion formulations and deep-line catheter use in premature infants pose a risk for disseminated Malassezia furfur infections.
  • Early recognition and prompt management are crucial to prevent severe morbidity and mortality associated with M. furfur fungemia in neonates.
  • This study underscores the importance of considering fungal infections in critically ill premature infants, especially those with prolonged catheter use and unexplained clinical deterioration.

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