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  • Perinatal/Neonatal Case Presentation
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Perinatal/Neonatal Case Presentation

Severe primary cutaneous aspergillosis refractory to amphotericin B and the successful treatment with systemic voriconazole in two premature infants with extremely low birth weight

Journal of Perinatology volume 26, pages 511–514 (2006)Cite this article

Abstract

Primary cutaneous aspergillosis is a rare, life-threatening, infectious complication in premature infants that may result in fulminant sepsis and subsequent multi-organ failure. In the past decade, the incidence of primary aspergillosis has increased significantly, whereas the high morbidity and mortality of invasive aspergillosis remains unaltered. In vitro studies reveal that more and more Aspergillus species seem to be refractory to the classical treatment with fluconazole or amphotericin B. This case report presents two extremely low birth weight infants (ELBW) with primary cutaneous aspergillosis, which was refractory to amphotericin B. Both patients were successfully treated with systemic voriconazole, an extended-spectrum triazole antifungal, supported by topical care. This paper provides the clinical manifestation, diagnostics and pharmacotherapy of primary cutaneous aspergillosis, as well as pharmacokinetic aspects of voriconazole in ELBW infants.

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Acknowledgements

We thank an anonymous peer reviewer for constructive feedback on the initial manuscript. We also thank Michael Hanna, PhD, for his support in revision and proofreading of the manuscript.

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Authors and Affiliations

  1. Department of Perinatology, University Hospital of Cologne, Cologne, Germany

    K Frankenbusch, F Eifinger, A Kribs & B Roth

  2. Department of Internal Medicine VI, Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Bergheimer, Heidelberg, Germany

    J Rengelshauseu

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  1. K Frankenbusch
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  2. F Eifinger
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  3. A Kribs
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  4. J Rengelshauseu
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  5. B Roth
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Correspondence to K Frankenbusch.

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Frankenbusch, K., Eifinger, F., Kribs, A. et al. Severe primary cutaneous aspergillosis refractory to amphotericin B and the successful treatment with systemic voriconazole in two premature infants with extremely low birth weight. J Perinatol 26, 511–514 (2006). https://doi.org/10.1038/sj.jp.7211532

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  • DOI: https://doi.org/10.1038/sj.jp.7211532

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