Fatal disseminated Acremonium strictum infection in a preterm newborn: a very rare cause of neonatal septicaemia

Division of Neonatology, Department of Pediatrics 1 , Department of Microbiology and Clinical Microbiology 2 and Department of Pathology 3 , Ege University Faculty of Medicine, Izmir, Turkey Correspondence Mete Akisu makisu{at}med.ege.edu.tr Received December 2, 2002 Accepted April 29, 2003 Species of the genus Acremonium ( Cephalosporium ) are opportunistic micro-organisms that are environmentally widespread saprophytes in soil and can, very rarely, be pathogenic in humans. Disseminated infection has been described in patients with immunodeficiency, but has previously been reported in only one neonate. A preterm infant with Acremonium strictum fungaemia is reported here. The patient was born at 27 weeks gestation and weighed 870 g at birth. She needed intensive respiratory management and became septic on day 11 of life. Blood and cerebrospinal fluid (CSF) cultures were positive for A. strictum . The patient did not respond to therapy with amphotericin B plus fluconazole and died on day 25 of life. The autopsy showed foci due to A. strictum in the brain, liver and heart. Abbreviations: CSF, cerebrospinal fluid; RDS, respiratory distress syndrome. A photograph showing A. strictum colonies from haemoculture is available as supplementary material in JMM Online.