Affiliations: Department of Pediatrics of King Abdul Aziz Medical
City, Riyadh, Saudi Arabia | Department of Pediatrics of Alwasl Hospital, Dubai,
United Arab Emirates
Note: [] Corresponding author: Dr. Khalil Al Tawil, Pediatrics
Department, Internal mail code 1510, King Abdul Aziz Medical City Riyadh, PO.
Box 22490, Riyadh 11426, Saudi Arabia. E-mail: tawilkio@yahoo.com
Abstract: Necrotizing fasciitis (NF) in premature infants is a rare, yet
life-threatening, soft tissue infection. We report four cases of NF that were
encountered over a seven-year period. The onset of the disease was between four
and twelve days of age. Predisposing factors were omphalitis in two infants and
intestinal perforation in the other two infants, one of whom had necrotizing
enterocolitis. Surgical biopsies from the affected sites showed mucormycosis in
one infant and bipolaris fungi in another. One of these infants was treated
with antifungal therapy in addition to broad spectrum antibiotics. This infant
survived, even without surgical intervention while the other three died. We
conclude that intestinal perforation and omphalitis are important predisposing
factors of NF in premature infants. Fungal infection should be considered as
one of the possible causes of NF in preterm infants. Early initiation of
antifungal therapy, in addition to broad spectrum antibiotics, is justifiable
in this disease entity.
