Neonatal Gastrointestinal Mucormycosis Clinically Mimicking Necrotizing Enterocolitis

Gastrointestinal Mucormycosis of Neonate Masquerading as Necrotising Enterocolitis

“…The other predisposing factors are preterm baby, steroid therapy, malnutrition, immunosuppression, low birth weight, immature immune system of the neonate with fragile skin barrier, orogastric intubation. (1,5,6,7,8) Members of mucoraceae show affinity for arterial invasion leading to thrombosis and ischaemic infarction of the tissue supplied by the artery. In gastrointestinal mucormycosis, this leads to gangrene of the involved bowel segment mimicking NEC (Necrotising Enterocolitis).…”

Neonatal Small Intestinal Zygomyocosis Misdiagnosed as Intussusception in a Two-Day-Old Child with a Review of the Literature

“…Based on clinical presentation and the involvement of anatomic site, mucormycosis can be divided into six clinical categories: (1) rhinocerebral, (2) pulmonary, (3) cutaneous, (4) gastrointestinal, (5) disseminated and (6) miscellaneous (brain, bones, mediastinum, trachea, kidneys) [1]. Only 18 case reports of neonates with GI mucormycosis have been described in the literature [5] and 13 cases of isolated neonatal GI mucormycosis have been reported from the Indian subcontinent [6]. The M:F ratio in these cases was 1.6:1, suggesting that males are more commonly affected than females.…”

Rare case of disseminated neonatal zygomycosis mimicking necrotizing enterocolitis with necrotizing fasciitis

“…Neonatal gastrointestinal zygomycosis usually mimics NEC clinically [5][6][7][8][9][10][11]. In zygomycosis, cultures of affected lesions are often negative, which can delay accurate diagnosis and administration of specific treatment.…”

“…No biologic or serologic diagnostic tests (eg, detection of antigens or antibody) has as yet been established, and genetic testing through polymerase chain reaction is still unavailable [1,5,7]. Consequently, the diagnosis usually depends on histopathologic examination of the surgically resected organs or the infected tissues at autopsy [2,[5][6][7]9,10]. Typical and characteristic histopathologic findings are as follows: (1) broad, aseptate filaments with right angle branching hyphae in tissue specimens and (2) typical hyphae showing features of perivascular and blood vessel invasion, particularly, arterial invasion, which can cause arterial thrombosis and subsequent ischemic necrotic changes in the tissue [2,[5][6][7][9][10][11].…”

“…Prompt diagnosis and early treatment of combining aggressive surgery and amphotericin B administration are necessary for patient survival [1][2][3]. However, antemortal diagnosis of gastrointestinal zygomycosis in the neonate is difficult, the clinical course mimics necrotizing enterocolitis (NEC) and is often diagnosed only by histopathologic examination [4][5][6][7][8][9][10]. Diagnostic delay frequently leads to a poor outcome.…”