Cutaneous aspergillosis in a premature infant

Fungal infections in preterm infants are uncommon but serious infections that carry a high mortality rate. Preterm infants who are extremely low birth weight are at high risk for fungal infections due to immaturity of their immune system and skin barrier. Factors which further reduce host immunity in premature infants include prolonged use of broad-spectrum antibiotics and corticosteroids. Our case presentation involves an extremely low-weight 23-week preterm infant diagnosed with primary invasive cutaneous aspergillosis (PCA) confirmed by skin biopsy and cultures obtained from skin debridement. His inoculation was thought to be secondary to either a thermal burn or macerated skin from prolonged incubation. This case highlights the importance of keeping fungal infections at the forefront of one's differential diagnosis when an extremely low-weight infant presents with cutaneous lesions, as disseminated fungal infections carry a high mortality rate.