Table 11

Demographic information, clinical and laboratory findings, therapeutic approaches, and outcomes of Malassezia furfur (sensu lato) systemic infections and miniepidemics in neonates reported in the English-language literature from 1981 to 2011 a

ReferenceGenderwt (g)Gestational age (wk)Identification procedure(s)ComorbidityAge at administration of TPN-LS (days)Age at infection (days)Clinical presentation(s)TherapyOutcome
7 NR67025CultureBPDNR30Apnea, bradycardiaRemoval of CVCFavorable
7 NR90027CultureBPDNR90AsymptomaticRemoval of CVCFavorable
7 NR2,91037CultureCyanotic congenital heart diseaseNR90Fever, respiratory distressRemoval of CVCFavorable
7 NR76027CultureNENR60Lethargy, atrial thrombus on ultrasound, leucocytosis, thrombocytopeniaRemoval of CVC plus treatment with amphotericin B plus fluorocytosineFavorable
7 NR1,25031CultureNENR60Removal of CVCFavorable
7 NR3,40040CultureNENR90Removal of CVCFavorable
7 NR1,12028CultureNENR45Apnea, bradycardia, respiratory distress, leucopenia, thrombocytopeniaRemoval of CVC plus amphotericin B treatmentFavorable
17 NR1,260NRCultureGastroschisis, NE1131CO, SCRemoval of CVCFavorable
17 NR3,000NRCultureGastroschisis, NE6684CO, SCRemoval of CVCFavorable
17 NR620NRCultureBPD1558CO, SCRemoval of CVCFavorable
17 NR580NRCultureBPD1870CO, fever, RDSRemoval of CVCFavorable
17 NR900NRCultureBPD1936Suspected sepsisRemoval of CVCFavorable
17 NR780NRCultureBPD414CO, SCRemoval of CVCFavorable
17 NR1,300NRCultureBPD420Apnea, bradycardia, suspected sepsisRemoval of CVCFavorable
17 NR1,480NRMild BPD925CO, SCRemoval of CVCFavorable
17 NR1,100NRMild BPD630CO, SCRemoval of CVCFavorable
17 NR1,210NRMild BPD424CO, SCRemoval of CVCFavorable
17 NR1,330NRMild BPD620Suspected NERemoval of CVCFavorable
17 NR1,500NRMild BPD2140CO, SCRemoval of CVCFavorable
72 F64025-26Culture of blood from Broviac catheterNE, hyperbilirubinemia, PDA3036ThrombocytopeniaRemoval of CVC plus amphotericin B treatmentFavorable
72 M1,52032Culture of blood from Broviac catheterPDA, apnea of prematurity, meconium plug, NE3643Positive blood cultureRemoval of CVC plus amphotericin B treatmentFavorable
72 M88026Culture of blood from Broviac catheterRecurrent apnea, chronic lung disease, NE1153Thrombocytopenia, leucopeniaChange of umbilical artery catheterFavorable
72 M3,34538Culture of blood from Broviac catheterPersistent fetal circulation, hydrocephalus, congenital malformations, Candida parapsilosis infection10195Positive blood cultureDiscontinuation of TPN with LS plus amphotericin B treatment, temporary sterilization change of catheter 20 days later due to positive Malassezia cultureFatal from Pseudomonas sepsis
72 M1,38029Culture of blood from Broviac catheterNE, colon resection834 (intermittent)Thrombocytopenia, leucopenia, deterioration of general conditionDiscontinuation of TPN with LS plus removal of CVCFavorable
124 M40Blood smear, cultureHirschsprung disease, bowel resection surgery, multiple catheter-associated bacterial sepsis episodes770Intermittent feverRemoval of CVC plus amphotericin B treatmentFavorable
152 NR<1,500∼24CultureBPDNRNRNRAmphotericin B treatment plus removal of the catheterFavorable
175 FNR34Buffy coat, cultureComplicated bowel resectionNR30Ecchymotic and purpuric lesions, leucopenia, thrombocytopeniaRemoval of CVC plus amphotericin B treatmentFavorable
203 F1,50034Buffy coat, cultureNE, bowel resection14120FeverRemoval of CVC plus amphotericin B treatmentFavorable
203 M2,50036Buffy coat, cultureSmall bowel volvulus, jejunostomy∼275FeverPeripheral catheter plus amphotericin B treatmentFavorable
203 F59027Buffy coat, cultureRespiratory failure, neutropenia, thrombocytopenia, gastric perforation, progressive hydrocephalus∼250Apnea, bradycardia, dusky color, lethargy, thrombocytopeniaRemoval of CVC plus amphotericin B treatmentFavorable
203 F1,38030Buffy coat, cultureNE, bowel resection∼790FeverDiscontinuation of TPN plus amphotericin B treatmentFavorable
235 M1,49030Gram stain of catheter occlusion precipitate, culture∼722Apnea, bradycardia, catheter occlusion, thrombus formationRemoval of CVCFavorable
235 F67025CultureSevere RDS, chronic lung disease128Precipitate in the catheter, adhesion of catheterRemoval of CVCFavorable
209 FNRNRCultureGastroschisis and postoperative short-gut syndromeYes∼180Miconazole and amphotericin B treatment, removal of CVCFavorable
209 MNRNRCultureGastroschisis and postoperative short-gut syndromeYes∼150Miconazole treatment and removal of CVCFavorable
251 MNR33CultureYes37Lethargy, seizures, apnea, bradycardia, hepatosplenomegaly, interstitial pneumonitis, thrombocytopeniaRemoval of CVCFavorable
251 FNR27CultureYes39Lethargy, apnea, bradycardia, interstitial pneumonitis, thrombocytopeniaRemoval of CVCFavorable
251 FNR31CultureYes46Apnea, bradycardia, interstitial pneumonitis, thrombocytopeniaRemoval of CVCFavorable
251 MNR28CultureYes70Apnea, bradycardia, interstitial pneumonitis, thrombocytopeniaRemoval of CVCFavorable
251 FNR40CultureChalasia and secondary interstitial pneumoniaYes336Fever, interstitial pneumonitis, thrombocytopeniaRemoval of CVCFavorable
252 F3,10039CultureGastroschisis, bowel resection, jejunoileal anastomosis, P. aeruginosa infection, methicillin-resistant staphylococcal sepsis3860Fever, cardiovascular instabilityRemoval of CVCFavorable
261 F74028PathologyRDS1042Amphotericin B treatmentFatal
265 M855 (mean)25 (mean)CultureHyaline membrane diseaseNoneFavorable
265 M855 (mean)25 (mean)PathologyHyaline membrane diseaseNoneFatal
270 56723Culture/gram stain of CSF, blood cultureNE, chronic lung disease, intraventricular hemorrhage124 (discontinuation/reinstitution at 62 days)Hypotension, thrombocytopenia/meningitisRemoval of CVC plus amphotericin treatmentFavorable/fatal
283 M80025AutopsyPDABilateral pneumonia, severe BPDFatal
283 F71026AutopsyPDA, NEFeverFatal
283 M76525AutopsyNE, pneumatosis intestinalis, PDARDS, feeding problems, bradycardia, intubation, severe BPD, hemorrhage into ventricles of brainFatal
291 NR1,40031CultureAsymptomatic317No symptoms, colonizationNoneFavorable
291 NR2,50040CultureCantrell's pentalogy3635Fever, worsening respiratory conditionDiscontinuation of TPN plus removal of CVCFatal
333 F1,30029Culture1049Fever, lethargy, apnea, bradycardiaDiscontinuation of TPNFavorable
283 M80025AutopsyPDA, ligation323Leucocytosis, X-ray-proven pneumoniaNoneFatal
192 F71026AutopsyPDA, NE, ileum resection164Hypoxemia, right atrial thrombusNoneFatal
192 M76525AutopsyRespiratory distress, NE, pneumatosis intestinalis, PDA ligation158Leucocytosis, bradycardiaNoneFatal
  • a TPN-LS, total parenteral nutrition with lipid supplementation; BPD, bronchopulmonary dysplasia; NR, not reported; CVC, central venous catheter; NE, necrotizing enterocolitis; CO, catheter occlusion; SC, stable condition; RDS, respiratory distress syndrome; PDA, patent ductus arteriosus; M, male; F, female; CSF, cerebrospinal fluid.