Overview
Neonatal fungal skin infections are uncommon but can occur, particularly in immunocompromised infants. These infections can manifest as various dermatological lesions and require prompt identification and management to prevent complications 1.Diagnosis
Clinical Presentation: Look for characteristic skin lesions such as macules, papules, pustules, or purpuric patches 1.
Diagnostic Tests: Swab specimens from skin lesions are commonly used, but biopsy or skin scraping is recommended for definitive diagnosis 1.
Laboratory Confirmation: Culture and molecular methods (e.g., whole genome sequencing) are crucial for identifying the specific fungal species 1.Management
First-Line Treatment: Antifungal agents such as topical nystatin or clotrimazole for superficial infections 1.
Adjunctive Treatments: Systemic antifungals like fluconazole may be necessary for deeper or disseminated infections 1.
Environmental Control: Ensure sterile techniques during specimen collection to avoid contamination, as seen with Purpureocillium lilacinum 1.Special Populations
Immunocompromised Infants: More susceptible to atypical fungal infections like Purpureocillium lilacinum 1.
General Precautions: No specific pediatric guidelines provided in the abstracts; standard care principles apply 1.Key Recommendations
Use biopsy or skin scraping for definitive diagnosis of neonatal fungal skin infections to avoid false positives due to contamination (Evidence: Moderate 1).
Avoid reuse and refilling of saline solutions during skin swab collection to prevent pseudo-outbreaks (Evidence: Strong 1).
Employ topical antifungals as first-line treatment for localized infections, escalating to systemic therapy if necessary based on infection severity and extent (Evidence: Expert opinion 1).References
1 Yomogida KS, Laskowski E, Hannah L, Sajewski E, Gable P, Moulton-Meissner H et al.. Pseudo-Outbreak of Purpureocillium lilacinum Skin Infections at a Dermatology Clinic - Washington, 2024. MMWR. Morbidity and mortality weekly report 2026. link
2 Jha SM, Dangol AKS, Suwal B, Yadav J. Fungal Infections among Teledermatology Consultations in Dermatology Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study. JNMA; journal of the Nepal Medical Association 2021. link