1 Division of Endocrinology and Diabetes, Blank Hospital for Children, Des Moines, IA 50308
To the Editor.
Baley et al, in "Disseminated Fungal Infections in Very Low-Birth-Weight Infants: Clinical Manifestations and Etiology" (Pediatrics 1984;73:144-152), provided a wealth of clinical detail about systemic candidiasis in very low-birth-weight infants and emphasized the increased risk in infants with a prolonged period of parenteral alimentation via central lines. They observed late-onset carbohydrate intolerance in these infected infants and imply that fungal sepsis may precipitate hyperglycemia.
The causal relationship and temporal sequence of such insidious conditions as hyperglycemia and candidemia may be difficult to establish in retrospect.