Cutaneous mucormycosis in an extremely premature infant

This case concerns a female infant born at 23+4/40 weighing 460 g. She was referred to us on day 6 with focal intestinal perforation, requiring small bowel resection and ileostomy. On day 7, skin necrosis was seen extending bilaterally from under the endotracheal tube (ETT) fixation (figure 1). Removing the device revealed extensive soft tissue damage. Honey dressings were applied and a non-adhesive method (bonnet & ties) used to resecure ETT. Antifungal prophylaxis was continued and antibiotics (tazocin, clindamycin, vancomycin) commenced as swabs from area grew Escherichia coli. Necrosis progressed to full thickness injury by day 11 (figure 2). Debridement of wounds was not felt to be a viable option due to anatomical position. Providing ongoing intensive care was impossible with progression of necrosis and no ways to secure respiratory support long term due to her size (ie, tracheostomy). Intensive care was stopped on day 12....
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - Category: Perinatology & Neonatology Authors: Tags: Images in neonatal medicine Source Type: research