Outcomes of Neonatal Gastrointestinal Mucormycosis: A Case Series

A BSTRACT Introduction: Neonatal gastrointestinal mucormycosis (GIM) often mimics necrotising enterocolitis (NEC), leading to delayed diagnosis. Our case series highlights histopathologically confirmed GIM with extraintestinal manifestations in three neonates, including hepatic abscess and cutaneous necrosis. Methods: A retrospective analysis of consecutive neonates with GIM managed in the intensive care unit at our center between January 2021 and December 2024 was conducted. Clinical records were reviewed for demographic details, investigations, operative findings, management, and outcomes. Case Summary: During the study period, four neonates with histopathologically confirmed GIM were identified. Three neonates were term and low birth weight, while one was very preterm. Three neonates initially presented with a clinical picture mimicking NEC, whereas one developed features of bowel ischemia following repair of a left congenital diaphragmatic hernia. The diagnosis of GIM was confirmed postoperatively on histopathological examination of resected bowel specimens. Extraintestinal manifestations included hepatic abscess and cutaneous necrosis, which were also proven on the excised tissue biopsy reports. Despite aggressive surgical intervention, antimicrobial therapy, and antifungal treatment, three neonates succumbed to the disease, while one survived. Conclusion: Neonatal GIM may be associated with extraintestinal manifestations, including hepatic abscess and cutaneous necrosis. Early histopathological diagnosis and aggressive surgical and antifungal management are crucial for improving survival.