Abstract
Sepsis is a life-threatening condition that has challenged many clinicians over the
years. The immune and hemostatic systems are the primary pillars of sepsis pathogenesis.
Dysregulation of these intricate mechanisms significantly worsens the prognosis. Coagulopathy
is a critical aspect of sepsis, with the degree of hemostatic impairment being a key
determinant of poor outcomes. Although the concept of sepsis caused by bacteria has
been well investigated, the fungal impact in the complexity of sepsis-related hemostatic
derangement is not yet fully unraveled. In addition, sepsis occurs in patients across
all age groups, with a particular concern for neonates, whose immature and vulnerable
systems amplify the challenges. Notably, despite the high incidence of fungal septicemia
in neonatal intensive care units (NICUs), along with its significant morbidity, mortality,
and adverse neonatal outcomes, the impact of fungal sepsis on the neonatal hemostatic
system—an essential determinant of prognosis—remains largely unexplored. The present
review delves into the pathophysiologic mechanisms of sepsis-induced coagulopathy
attributed to fungal infection, the mechanisms of fungal involvement in the hemostatic
derangement, and attempts to contextualize this knowledge within the unique neonatal
population. Finally, it aims to raise awareness of the critical need for a deep understanding
of this hazardous condition to guide the development of optimal therapeutic strategies.
Keywords hemostasis - fungal infections - platelets - sepsis-induced coagulopathy - neonates
