Gastric mucormycosis: A case report

作     者：Mpho Klaas Kgomo Ali Ahmed Elnagar Kgataki Mashoshoe P Thomas W G Van Hougenhouck-Tulleken 

作者机构：Department of Gastroenterology University of Pretoria 

出 版 物：《World Journal of Clinical Infectious Diseases》 (世界临床传染病学杂志)

年 卷 期：2018年第8卷第1期

页      面：1-3页

学科分类：10[医学] 

主　　题：Gastric Mucormycosis Human deficiency virus Candidiasis Amphotericin B Diflucan Pneumonia Tuberculosis Gastrointestinal bleed 

摘      要：Mucormycosis is a rare fungal infection which is largely diagnosed in immune-compromised patients. The infection can cause pulmonary, rhinocerebral, skin and soft tissue, central nervous system and gastrointestinal system. The gastrointestinal involvement is the rarest presentation, especially the stomach. We present a 38 years old HIV positive female seen in Steve Biko Academic Hospital with 2 wk history of cough, shortness of breath and lethargy. She was clinically found to be pale, pyrexial, dyspnoea and had severe oral thrush. Blood tests revealed hemoglobin of 6 g/dL CD4 count of 63 cells/uL. Chest X-ray showed multi-lobe pneumonia and gastroscopy confirmed esophageal candidiasis and nodular gastritis. She continued to deteriorate despite antibiotics, antifungal and antituberculous treatment. She developed upper gastrointestinal bleed on day 34, and gastroscopy showed a plaque like lesion in the stomach, histology of which confirmed mucormycosis. She improved on Amphotericin B but subsequently deteriorated and demised a few days later. These cases illustrate the occurrence of a rare fungal infection of the stomach and the poor mortality when diagnosis is delayed. Mucormycosis can co-exist with candidiasis and clinicians should have a high index of suspicion especially in patients not responding to appropriate treatment.