Systemic fungal infections in neonates.

Systemic fungal infections, previously considered to be a rare complication, are now frequently diagnosed in VLBW infants receiving intensive care. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. Prompt and aggressive use of antifungal treatment is justified in a clinically septic neonate, especially those with a raised serum concentration of C reactive protein, who do not show a satisfactory response to antibiotics. The newer generation of liposomal amphotericin and azole antifungal drugs appear to be safe, effective, and well tolerated. With increasing awareness, prompt treatment, and better neonatal intensive care, the outcome of systemic fungal infection in preterm infants should improve.