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Neonatal gastrointestinal mucormycosis--a case report
Monisha Choudhury1, Eram Kahkashan, Subhasish Roy Choudhury
1Department of Pathology, Lady Hardinge Medical College, New Delhi.
Abstract:
Mucormycosis is a rare opportunistic fungal infection. It occurs mainly in immunocompromised patients and is usually fatal in children. This fungus can affect central nervous system, nasopharynx, lungs, skin and gastrointestinal tract. It invades the blood vessels and causes thrombosis, leading to infarction of the surrounding tissues. The diagnosis depends mainly on histopathological examination and demonstration of the fungus in the tissue sections, therefore a high index of suspicion and early exploration is required. We report a case of malnourished child who presented with perforation peritonitis. Investigations revealed very low total serum proteins and raised serum creatinine and blood urea levels. On exploratory laparotomy three perforations were located in the gastrointestinal tract. Histopathlogical examination of the perforation edge sections showed characteristic fungal hyphae confirming the diagnosis of gastrointestinal mucormycosis.
Insights
Gastrointestinal mucormycosis is a rare, often fatal fungal infection in immunocompromised children. Early diagnosis through histopathology is crucial for this severe condition, as seen in a malnourished child with perforation peritonitis.
Area of Science:
- Mycology
- Pediatric Infectious Diseases
- Gastroenterology
Background:
- Mucormycosis is a rare opportunistic fungal infection primarily affecting immunocompromised individuals.
- It can be fatal in children and affect various organs, including the gastrointestinal tract.
- Diagnosis relies on histopathology, necessitating high clinical suspicion.
Observation:
- A case of a malnourished child presented with perforation peritonitis.
- Investigations revealed malnutrition, low serum proteins, and elevated kidney function markers.
- Exploratory laparotomy identified three gastrointestinal perforations.
Findings:
- Histopathological examination of perforation edges confirmed gastrointestinal mucormycosis.
- Fungal hyphae invasion of blood vessels led to thrombosis and tissue infarction.
Implications:
- This case highlights the importance of considering gastrointestinal mucormycosis in severely ill, malnourished children with abdominal emergencies.
- Early surgical exploration and prompt histopathological diagnosis are critical for timely treatment and improved outcomes.
- Further research into risk factors and diagnostic strategies for pediatric gastrointestinal mucormycosis is warranted.
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