Post-traumatic abdominal mucormycosis

Taams, Meindert A.; Bade, Patrick; Thomson, S.R.

doi:10.1016/0020-1383(92)90014-j

Cited by 10 publications

(5 citation statements)

References 12 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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“…The invasive form has a very high mortality. Antifungal treatment is often delayed because the diagnosis is only revealed after the histological examination and its bearing on the outcome in severe gastrointestinal mucormycosis is unclear 5 , 6…”

Section: Discussionmentioning

confidence: 99%

Ileosigmoid knot complicated by gastric and splenic mucormycosis: a lethal combination

Islam¹,

Thomson

Tudor

et al. 2009

Case Reports

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Two very rare conditions, ileosigmoid knot and intra-abdominal mucormycosis, occurred sequentially in a middle-aged HIV positive male.At laparotomy for peritonitis, a gangrenous sigmoid volvulus with ileosigmoid knot was resected; 2 days later, colo-rectal continuity was restored, the distal ileum stapled and an end jejunostomy fashioned.At re-laparotomy on day 15, necrotic stomach and spleen required a total gastrectomy and splenectomy. At reoperation 2 days later, a bile leak at the oesophago-jejunostomy site was repaired. Despite this intervention he continued to deteriorate and died of multiple organ failure 4 days later.

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“…Finally, mucormycosis may occur after traumatic inoculation, especially in those cases where the inoculation is accompanied by contamination with water and soil. Mortality in these circumstances fluctuates between 38% and 80%[101,126–147].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Mucormycosis: an emerging disease?

Bouza

Muñóz

Guinea

2006

Clinical Microbiology and Infection

137

127

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A B S T R A C TMucormycosis is the third invasive mycosis in order of importance after candidiasis and aspergillosis and is caused by fungi of the class Zygomycetes. The most important species in order of frequency is Rhizopus arrhizus (oryzae). Identification of the agents responsible for mucormycosis is based on macroscopic and microscopic morphological criteria, carbohydrate assimilation and the maximum temperature compatible with its growth. The incidence of mucormycosis is approximately 1.7 cases per 1000 000 inhabitants per year, and the main risk-factors for the development of mucormycosis are ketoacidosis (diabetic or other), iatrogenic immunosuppression, use of corticosteroids or deferoxamine, disruption of mucocutaneous barriers by catheters and other devices, and exposure to bandages contaminated by these fungi. Mucorales invade deep tissues via inhalation of airborne spores, percutaneous inoculation or ingestion. They colonise a high number of patients but do not cause invasion. Mucormycosis most commonly manifests in the sinuses (39%), lungs (24%), skin (19%), brain (9%), and gastrointestinal tract (7%), in the form of disseminated disease (6%), and in other sites (6%). Clinical diagnosis of mucormycosis is difficult, and is often made at a late stage of the disease or post-mortem. Confirmation of the clinical form requires the combination of symptoms compatible with histological invasion of tissues. The probable diagnosis of mucormycosis requires the combination of various clinical data and the isolation in culture of the fungus from clinical samples. Treatment of mucormycosis requires a rapid diagnosis, correction of predisposing factors, surgical resection, debridement and appropriate antifungal therapy. Liposomal amphotericin B is the therapy of choice for this condition. Itraconazole is considered to be inappropriate and there is evidence of its failure in patients suffering from mucormycosis. Voriconazole is not active in vitro against Mucorales, and failed when used in vivo. Posaconazole and ravuconazole have good activity in vitro. The overall rate of mortality of mucormycosis is approximately 40%.

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Post-traumatic abdominal mucormycosis

Cited by 10 publications

References 12 publications

Gastrointestinal mucormycosis in apparently immunocompetent hosts—A review

Gastrointestinal mucormycosis in apparently immunocompetent hosts—A review

Ileosigmoid knot complicated by gastric and splenic mucormycosis: a lethal combination

Mucormycosis: an emerging disease?

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