Invasive Gastric Mucormycosis—a Case Report

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• 作者：Rugved V. Kulkarni ; Sanjiv S. Thakur
• 关键词：Invasive gastric mucormycosis ; Perforative peritonitis ; Diabetes ; Alcoholism
• 刊名：Indian Journal of Surgery
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：77
• 期：1-supp
• 页码：87-89
• 全文大小：438 KB
• 参考文献：1.Spellberg B (2012) Gastrointestinal mucormycosis: an evolving disease. Gastroenterol Hepatol 8:140-
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• 作者单位：Rugved V. Kulkarni (1)
  Sanjiv S. Thakur (1)
  
  1. Department of General Surgery, Byramjee Jeejeebhoy Medical College, Pune, 411001, Maharashtra, India
  
• 刊物主题：Surgery; Pediatric Surgery; Neurosurgery; Plastic Surgery; Cardiac Surgery; Thoracic Surgery;
• 出版者：Springer India
• ISSN：0973-9793

文摘

Mucormycosis is an opportunistic fungal infection that is associated with high mortality in immunocompromised individuals. While rhinocerebral and pulmonary forms are most common, primary gastrointestinal mucormycosis is very uncommon. The stomach is the most commonly affected organ followed by the colon and ileum in alimentary zygomycosis. We report a rare case of invasive gastric mucormycosis in a 50-year-old diabetic gentleman with a history of chronic alcoholism presenting with complaints of pain and distension of the abdomen for 6?days associated with fever, nausea, vomiting and anorexia. At presentation, he was hemodynamically unstable, febrile with uncontrolled blood sugar level and had negative HIV serology. There was generalized guarding, rigidity and distension of the abdomen and investigations confirmed perforative peritonitis. Upon exploration, there was solitary large 4?×-?cm size perforated ulcer in the gastric body with greenish, greyish sloughed out mucosa within. Wedge resection of the ulcer with primary closure was performed. Histopathology revealed aseptate, broad, obtuse angled fungal hyphae, and invasive mucormycosis was confirmed by special stains like Periodic acid-Schiff (PAS) and Gomori′s methenamine silver (GMS). Very few cases of invasive gastric mucormycosis associated with uncontrolled diabetes and alcoholism have been reported in the literature. Delayed presentation of the patient along with rapid progression to fungal septicaemia resulted in the case fatality despite early surgical intervention and critical care management.