Neonatal systemic candidiasis.

Systemic candidiasis is notoriously difficult to diagnose in neonates; however, it is frequently described and has a high mortality and morbidity. It is particularly likely to occur in extremely low birthweight babies, especially those receiving long-term parenteral nutrition and antibiotics. The clinical features are non-specific. Thrombocytopenia occurs in almost all cases of systemic candidiasis, but also in about half the cases of bacterial sepsis. Empirical antifungal therapy should be considered more readily for high-risk, clinically septic, thrombocytopenic babies.