We are reporting a case of disseminated aspergillosis in a very low birth weight baby (birthweight 800 g; gestation 27 wk). After 4 days of admission in the Neonatal Intensive Care Unit, the baby developed fever, respiratory distress and lethargy. On 7th day, a maculopapular rash with grayish discoloration of skin was noticed. Child was screened for sepsis and subjected to lumbar puncture. CSF microscopy revealed pus cells and thin hyaline septate fungal hyphae. culture on Sabouraud’s Dextrose Agar (SDA) demonstrated white granular mycelial growth. which was confirmed as Aspergillus fumigatus. The same fungus was also isolated from blood culture.

Mother and baby were non-reactive for HIV antibodies. Fluconazole 6mg/kg/day was started intravenously, and continued for 30 days. The baby responded well and could be finally discharged at a weight of 3 Kg, on breastfeeding.

Very few cases of Aspergillus infection in premature babies are reported previously; most of them had cutaneous aspergillosis(1,2). We report this case for its rarity and dramatic response to therapy.