Affiliations: Department of Neonatology, Childrens's Hospital,
University of Bonn, Bonn, Germany | Department of Pediatric Oncology and Hematology,
Childrens' s Hospital, University of Saarland, Saarland, Germany | Department of Pediatric Pathology, University of Bonn,
Bonn, Germany
Note: [] Correspondence: Soyhan Bagci, Department of Neonatology,
Children's Hospital, University of Bonn, Adenauerallee 119, D-53113, Bonn,
Germany. Tel.: +49 228 287 33408; Fax: +49 228 287 16291; E-mail:
soyhan.bagci@ukb.uni-bonn.de
Abstract: Aspergillosis is an uncommon diagnosis in neonates, especially if
caused by Aspergillus flavus. Although amphotericin B remains the drug of
choice for treatment of invasive aspergillosis, Aspergillus flavus has been
reported as being resistant to amphotericin B. We present here a case of a
24-week gestational age preterm infant who developed skin and invasive
intestinal Aspergillus flavus infection after laparotomy for necrotizing
enterocolitis. Aspergillus flavus was first isolated from the smear of the
umbilical stump at the third postoperative day. The initial response to
antimycotic treatment with amphotericin B and caspofungin was not sufficient.
Because of continued disseminated infection and multiple intra-abdominal
abscesses with necrotic areas of the liver, a second surgical intervention was
performed on the 24th day of life. Antimycotic therapy was continued for
approximately 43 days so as to ensure clinical remission. No adverse events
were observed. This case supports the importance of the combination of surgery
and newer antimycotic drugs for the outcome of premature infants with invasive
aspergillosis.
