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Perforation of the appendix from intestinal mucormycosis in a neonate

Peter F Nichol1, Robert F Corliss, Sharad Rajpal

  • 1Department of Surgery, University of Wisconsin, Madison, WI, USA.

Journal of Pediatric Surgery
|June 24, 2004
PubMed

Insights

A premature infant developed pneumoperitoneum after extracorporeal membrane oxygenation (ECMO) therapy, revealing a perforated appendix. Fungal infection, specifically mucormycosis, was identified as the cause in this rare case.

Area of Science:

  • Neonatal Medicine
  • Surgical Pathology
  • Infectious Diseases

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life-support measure for neonates with severe cardiorespiratory failure.
  • Gastrointestinal complications can arise during or after ECMO therapy.
  • Fungal infections, though rare, pose a significant risk in critically ill neonates.

Observation:

  • A premature neonate presented with pneumoperitoneum five days post-ECMO discontinuation.
  • Exploratory laparotomy revealed a perforated appendix as the source of intra-abdominal air.

Findings:

  • Pathologic examination confirmed the appendix perforation.
  • Microscopic analysis identified mucormycosis, a rare fungal infection, within the appendix tissue.

Implications:

  • This case highlights mucormycosis as a potential cause of gastrointestinal perforation in neonates, particularly those who have undergone ECMO.
  • Early recognition and diagnosis of fungal infections are crucial for timely intervention in critically ill neonates.
  • Further research into the risk factors and management of fungal-related gastrointestinal complications post-ECMO is warranted.

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