Recovery of Malassezia pachydermatis from eight infants in a neonatal intensive care nursery: clinical and laboratory features.

A 15-month retrospective survey of 507 admissions to a neonatal intensive care unit revealed 8 patients from whom Malassezia pachydermatis was isolated from one or more clinical specimens. The fungus was cultured from blood (four patients), central venous catheter tips (three patients), urine (four patients), cerebrospinal fluid (one patient), eye discharge (one patient), ear discharge (one patient) and tracheal aspirate (one patient). Seven of the eight infants displayed an episode of one or more of the following symptoms: apnea, bradycardia, temperature instability and hepatosplenomegaly. These episodes were temporally related to recovery of M. pachydermatis from clinical specimens. The seven symptomatic infants had received multiple antibiotics as well as long term hyperalimentation, including lipids, by infusion through deep vein catheters; the single asymptomatic infant did not. These data suggest an association between M. pachydermatis and the febrile systemic syndrome of neonates recently described for extracutaneous infections due to Malassezia furfur.