Mixed infection with unusual fungi and staphylococcal species in two extremely premature neonates.

Systemic fungal infections are being recognized with increasing frequency in extremely premature neonates. We report two such infants with late-onset mixed infection with Staphylococcal species and unusual fungi. These cases are of interest in view of recent reports on the interaction of Staphylococcal cell wall components and neutrophils, as damaged skin sites could form a nidus and portal of entry for saprophytic fungal pathogens. It is also important to consider fungal infection as a possibility in sick premature infants with necrotic skin lesions even when the systemic signs have an alternative explanation with ongoing bacteremia.