Gastric Mucormycosis in an Alcoholic with Review of the Literature

Ho, Yew Kam; Wu, Bor-Gang; Chen, Yanzhong; Wang, Lih-Shinn

doi:10.1016/s1016-3190(10)60011-0

Cited by 13 publications

(8 citation statements)

References 10 publications

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“…A total of 200 cases of GI mucormycosis in non‐classical immunosuppressed or apparently immunocompetent hosts reported during 1948 through 2017 in English literature . The case details could be retrieved for 176 cases.…”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal mucormycosis in apparently immunocompetent hosts—A review

Kaur

Ghosh

Rudramurthy

et al. 2018

Mycoses

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The diagnosis of gastrointestinal (GI) mucormycosis is always a challenge due to its non-specific clinical presentations and often diagnosed at autopsy. Recently increased number of GI mucormycosis has been reported in immunocompetent hosts and during 1948 through 2017, 200 cases of GI mucormycosis are available in literature. We could review 176 cases where case details were available. Majority (50.6%) of the cases were reported from Asia. The disease is nearly equally recorded in adults and paediatric population. The infection commonly affected the intestine (64.2%) followed by stomach (33%). A significant improvement in antemortem diagnosis was noted since 2001. Rhizopus species were the predominant (67.5%) aetiological agents. Amphotericin B was the most commonly used drug (93.4%). Despite improvement of antemortem diagnosis and therapy, the mortality was 60.5% and 67.5% in adults and children respectively. Combined medical and surgical therapy (reported in 47.8% patients) had significantly better survival rate than those receiving either of them. Analysing the clinical presentations, we propose to suspect GI mucormycosis in a malnourished/ dehydrated child (especially premature neonate) with history of exposure to broad-spectrum antibiotics or formula/spoon feeding and presenting with mass in abdomen, abdominal distension or bilious vomiting; and an adult presenting with abdominal distension, fever or GI bleed with underlying risk factors for mucormycosis.

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Section: Resultsmentioning

confidence: 99%

Gastrointestinal mucormycosis in apparently immunocompetent hosts—A review

Kaur

Ghosh

Rudramurthy

et al. 2018

Mycoses

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“…Our case had no traditional risk factors often predisposing the patient to invasive mucormycosis. We only identified chronic alcoholic usage and early signs of liver cirrhosis as underlying risk factor in our patient [4,7]. Despite the fact that invasive mucormycosis is lethal in more than half of the patient [1], yet our patient showed excellent clinical responses to anti-fungal treatment alone without surgical resection of necrotic tissue.…”

Section: Discussionmentioning

confidence: 71%

Invasive intestinal mucormycosis in a 40-year old immunocompetent patient - a rarely reported clinical phenomenon: a case report

Wotiye

Ayele

2020

BMC Gastroenterol

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Background: Mucormycosis is rare, life-threatening fungal infection. Frequently observed in those patients having underlying immunosuppression such as, diabetes, organ transplantation, Human immunodeficiency virus (HIV) infection, and elevated serum iron. However, invasive intestinal mucormycosis occurring in immunocompetent individuals without the traditional risk factors is extremely rare clinical phenomenon. Case presentation: We report a 40-year-old male patient who presented with 1 week history of diffuse abdominal pain and high grade fever, associated with vomiting and frequent loose stools. Has history of chronic alcohol ingestion. Otherwise, no past history of chronic medical illness, nor he had contact with individuals with similar illness. He was in a septic shock with multiple organ failure up on presentation to emergency room. Physical examination revealed icterus sclera with abdominal tenderness. He was immediately resuscitated using crystalloids, supported with inotrope, and antibiotics. Histopathological examination of tissue sample from colonic ulcer biopsy revealed invasive intestinal mucormycosis. Patient showed full clinical and histopathological resolution after course of parenteral Liposomal Amphotercin B. Conclusion: This case highlights the fact that, despite its life-threatening nature, it's possible to treat patients with invasive intestinal mucormycosis with aggressive antifungal and supportive care without surgical intervention, provided that all the necessary supportive care were initiated early and the disease was diagnosed early and appropriate medical management was initiated timely. In addition, it's important to consider intestinal mucormycosis even in patients who are immunocompetent without traditional risk factors.

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“…Although gastric mucormycosis in patients with alcoholic liver cirrhosis has rarely been reported, alcoholism appears to be a risk factor of gastric mucormycosis . In literature, four cases of gastric mucormycosis in patients with alcoholism are reported . Ho et al reported that the ingestion of fungal spores and their germination may be harmful to a patient with alcoholism as ethanol may disrupt the activation of macrophages and dendritic cells, which play crucial role in the elimination of fungal spores.…”

Section: Discussionmentioning

confidence: 99%

Gastric mucormycosis: Diagnosis by imprint cytology

Tathe

Dani

Chawhan

et al. 2016

Diagnostic Cytopathology

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The fungi in the order of Mucorales commonly target diabetics and other immunocompromised hosts, producing fatal respiratory and or CNS infections. Gastrointestinal mucormycosis is uncommon and seldom diagnosed in living patients due to nonspecific clinical manifestations. We report a case of gastric mucormycosis in an immmunocompetent male patient, diagnosed by imprint cytology-a rare site and a rare setting. To the best of our knowledge, this is only the second report of gastric mucormycosis being diagnosed on cytology. As the disease is rapidly progressive and often fatal, early diagnosis is critical to the patient survival. Imprint cytology or brush cytology is extremely useful for the rapid diagnosis of gastric mucormycosis as these organisms are morphologically distinct. Familiarity with the cytomorphology of these organisms assists in the correct diagnosis of this disease. Diagn. Cytopathol. 2016;44:820-822. © 2016 Wiley Periodicals, Inc.

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Gastric Mucormycosis in an Alcoholic with Review of the Literature

Cited by 13 publications

References 10 publications

Gastrointestinal mucormycosis in apparently immunocompetent hosts—A review

Gastrointestinal mucormycosis in apparently immunocompetent hosts—A review

Invasive intestinal mucormycosis in a 40-year old immunocompetent patient - a rarely reported clinical phenomenon: a case report

Gastric mucormycosis: Diagnosis by imprint cytology

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