Neonatal Acute Liver Failure Associated with Angioinvasive Hepatic Zygomycosis

Area of Science:

• Mycology
• Neonatology
• Pathology

Background:

• Neonatal acute liver failure (NALF) is a critical and often fatal condition in infants.
• Hepatic zygomycosis, a fungal infection of the liver, is rare and typically associated with immunosuppression in both adults and neonates.
• Few cases of hepatic zygomycosis in neonates have been documented.

Observation:

• A post-mortem liver biopsy was performed on a 14-day-old neonate.
• The biopsy revealed confluent panacinar necrosis, indicative of severe liver damage.
• Angioinvasive zygomycosis was identified as the cause of the liver pathology.

Findings:

• The neonate presented with clinical signs consistent with NALF.
• The liver pathology demonstrated angioinvasive zygomycosis.
• An underlying immunodeficiency could not be definitively excluded due to limited work-up.

Implications:

• Angioinvasive hepatic zygomycosis should be considered in the differential diagnosis of NALF in neonates.
• Early recognition and diagnosis are crucial for potential intervention, although prognosis remains poor.
• This case expands the understanding of zygomycosis presentation in the neonatal intensive care unit (NICU).