title: Notes from the field: Fatal gastrointestinal mucormycosis in a premature infant associated with a contaminated dietary supplement--Connecticut, 2014.
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.
authors.forename: Snigdha
authors.initials: S
authors.lastname: Vallabhaneni
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Walker
authors.forename: Shawn R
authors.initials: SR
authors.lastname: Lockhart
authors.forename: Dianna
authors.initials: D
authors.lastname: Ng
authors.forename: Tom
authors.initials: T
authors.lastname: Chiller
authors.forename: Richard
authors.initials: R
authors.lastname: Melchreit
authors.forename: Mary E
authors.initials: ME
authors.lastname: Brandt
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Smith
mesh_terms: D003237:Connecticut; D019587:Dietary Supplements / Q000009:adverse effects*; D017809:Fatal Outcome; D005506:Food Contamination; D005759:Gastroenteritis / Q000175:diagnosis* / Q000209:etiology; D041981:Gastrointestinal Tract / Q000098:blood supply; D006801:Humans; D007225:Infant Food / Q000009:adverse effects*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000209:etiology; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology; D008297:Male; D009091:Mucormycosis / Q000175:diagnosis* / Q000209:etiology