Early recognition and management of primary cutaneous aspergillosis in an extremely preterm neonate associated with an umbilical catheter

Primary cutaneous aspergillosis is a rare fungal infection in extremely preterm neonates. We report a male infant born at 25+5 weeks’ gestation who developed necrotic lesions at the site of an umbilical catheter covered with an occlusive dressing. Culture confirmed Aspergillus fumigatus , and systemic liposomal amphotericin B combined with local enzymatic debridement and a non-adherent silicone wound contact layer was initiated after receipt of the culture result. The lesions resolved completely, leaving only a fine residual scar without functional impairment. This case emphasises the importance of early recognition, culture-based diagnosis and timely antifungal therapy in preterm neonates with catheter-related skin lesions, even when standard antifungal prophylaxis has been administered.