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Gastrointestinal Mucormycosis in Neonates: a Review

Abstract

Gastrointestinal mucormycosis is a rare but nearly always fatal disease and accounts for more than half of all mucormycosis infections among neonates. Premature birth is the primary risk factor, though malnutrition, hyperglycemia, acidosis, asphyxia, corticosteroid use, recent surgery, instrumentation with orogastric or nasogastric tubes, and exposure to contaminated products have also been implicated. A combination of impaired mucosal integrity and an immature immune system likely contribute to development of infection. Clinical manifestations can mimic necrotizing enterocolitis and can include abdominal pain and distention, vomiting, hematochezia, fever, peritonitis, and sepsis. Diagnosis is challenging because there are no pathognomonic clinical or radiographic signs, and organisms may not be found on culture; diagnosis is often based on evidence of organisms in tissue and signs of angioinvasion on histopathology. Treatment involves a combination of surgery and antifungal therapy. Mortality is extremely high at nearly 80 % but may be reduced with early surgical and medical intervention.

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Snigdha Vallabhaneni and Rajal K. Mody declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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The findings and conclusions in this paper are those of the authors alone and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

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Correspondence to Snigdha Vallabhaneni.

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This article is part of the Topical Collection on Epidemiology of Fungal Infections

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Vallabhaneni, S., Mody, R.K. Gastrointestinal Mucormycosis in Neonates: a Review. Curr Fungal Infect Rep 9, 269–274 (2015). https://doi.org/10.1007/s12281-015-0239-9

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Keywords

  • Mucormycosis
  • Zygomycosis
  • Gastrointestinal
  • Neonates
  • Neonatal
  • Epidemiology
  • Risk factors
  • Pathogenesis
  • Clinical presentation
  • Treatment
  • Outcomes
  • Mortality