Fatal gastrointestinal mucormycosis in a premature infant associated with a contaminated dietary supplement — Connecticut, 2014

• Type of Material: Article
• Authors: Snigdha Vallabhaneni, Centers for Disease Control and Prevention; Tiffany Walker, Emory University; Shawn R. Lockhart, Centers for Disease Control and Prevention; Dianna Ng, Centers for Disease Control and Prevention; Tom Chiller, Centers for Disease Control and Prevention; Richard Melchreit, Connecticut Department of Public Health; Mary E. Brand, Centers for Disease Control and Prevention; Rachel M. Smith, Centers for Disease Control and Prevention
• Language: English
• Date: 2015-02-20
• Publisher: Centers for Disease Control
• Publication Version: Final Published Version
• Copyright Statement: All material in the MMWR Series is in the public domain and may be used and reprinted without permission
• License: Creative Commons Universal : Public Domain Dedication
• Title of Journal or Parent Work: Morbidity and mortality weekly report. Surveillance summaries : MMWR
• Volume: 64
• Issue: 6
• Start Page: 155
• End Page: 156
• Keywords: Food Contamination; Humans; Ischemia; Gastrointestinal Tract; Mucormycosis; Dietary Supplements; Infant Food; Fatal Outcome; Connecticut; Infant, Newborn; Gastroenteritis; Male; Infant, Premature, Diseases
• Research Categories: Health Sciences, Nutrition

Abstract

In October 2014, a hospital in Connecticut notified CDC and the Connecticut Department of Public Health of a fatal case of gastrointestinal mucormycosis in a preterm infant. The infant, born at 29 weeks' gestation and weighing 1,400 grams (about 3 pounds), had developed signs and symptoms initially consistent with necrotizing enterocolitis approximately 1 week after birth. Exploratory laparotomy revealed complete ischemia of the gastrointestinal tract from the esophagus to the rectum; a portion of necrotic cecum was sent for microscopic examination. Following surgery, the infant developed multiple areas of vascular occlusion, including a large clot in the aorta, findings not usually associated with necrotizing enterocolitis. The infant died soon after. Histopathology results from the resected cecum revealed an angioinvasive fungal infection consistent with mucormycosis. Gastrointestinal mucormycosis is an extremely rare fungal infection caused by mold in the order Mucorales. It occurs predominantly in low birth weight infants, patients with diarrhea and malnutrition, and those receiving peritoneal dialysis; mortality is 85%. Local investigation revealed that the infant had received a dietary supplement, ABC Dophilus Powder, for 7 days, beginning on day 1 of life.