Cecal perforation secondary to fungal necrotizing enterocolitis in a premature neonate. (September 2021)

• Record Type: Journal Article
• Authors: Onyebuchi, Christina; Sommerhalder, Christian; Tran, Sifrance; Radhakrishnan, Ravi; Ukudeyeva, Aijan; Qiu, Suimmin; Bowen-Jallow, Kanika A.
• Is Part Of: International journal of surgery case reports. Volume 86(2021)
• Publication Date: 2021-09
• Subjects: Necrotizing -- Enterocolitis -- Fungal -- Candida Albicans -- Premature neonates -- Cecal perforation -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.106304
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction: Necrotizing enterocolitis (NEC) remains one of the most critical gastrointestinal comorbidities associated with neonatal prematurity and low birth weight. Despite extensive research and innovations for successful management, NEC remains the leading cause of morbidity and mortality in premature infants. NEC is commonly appreciated at the level of the small bowel, but in rare instances, it is experienced at the colon. While colonic perforation is rare, cecal perforation, specifically, is seldom reported. Case report: We report the successful surgical intervention of a preterm African-American infant born at 24-weeks' gestation found to have a cecal perforation due to fungal necrotizing enterocolitis. Discussion: Perforation is a major cause of morbidity in necrotizing enterocolitis, and even with extensive research in the management of necrotizing enterocolitis, mortality rates have remained unchanged; the treatment option with the most advantageous outcomes is still uncertain. Conclusion: To our knowledge, there are few reported cases of cecal perforation due to NEC. The pathologic report of our colonic specimen demonstrated mucosal invasion with Candida Albicans . This case report is noteworthy due to the unusual location of bowel perforation, fungal sepsis, and successful surgical outcome that is not commonly seen in neonates with intestinal candidiasis. Cecal perforation is rare in necrotizing enterocolitis but should not rule out the pathology. Highlights: Surgical treatment of fungal necrotizing enterocolitis in neonates Low survivability of fungal necrotizing enterocolitis in neonates, novel case of survival Candida Albicans as a cause of cecal perforation Colonic mucosal invasion of Candida Albicans