Synchronous Small Bowel Gangrene With Pyelonephritis Secondary to Mucormycosis: A Disastrous Complication of COVID-19 Pandemic

Abstract

Mucormycosis is a rare infection caused by fungi of the order Mucorales. The infection frequently involves the rhino-cerebral or respiratory system and involvement of the gastrointestinal (GI) tract and kidney are rare. It usually infects immunocompromised individuals due to various causes and an upsurge is hypothesized to be linked with irrational use of steroids during coronavirus disease 2019 (COVID-19) pandemic.We encountered a rare case of systemic mucormycosis that involved both renal as well as mesenteric vessels and led to ischemia of both vital organs. The patient developed massive bowel gangrene involving the duodenum, proximal jejunum, and left kidney due to angioinvasive mucormycosis.The diagnosis of GI mucormycosis may further increase during the current pandemic. The physicians, as well as surgeons, should be aware of this unwanted complication and keep a high index of suspicion for this rare disease.

Mucormycosis and Role of COVID-19 in its Pathogenicity in India: A Review

“…This leads to a condition of acidic medium and high levels of iron in serum and immunosuppressed state from the poor activity of phagocytic white blood cells. [53] About 94% of all who are suffering from black fungus in India are also suffering from diabetes [54] and as per the International Diabetes Federation, 57% of diabetic patients are undiagnosed in India, Nepal, Bangladesh, and Sri Lanka (Figure 3). It is this unreported occurrence of diabetes that is preventing early diagnosis of probable cases of black fungus in India.…”

Post-COVID-19 Intestinal and Mesenteric Mucormycosis

“…2 Two cases with similar pathology have been reported from India till now, ours being the third. 3,4 Our patient was an uncontrolled diabetic with a history of COVID-19 infection in the past 2 weeks. She, however, had only mild COVID-19 symptoms, and no history of administration of immunosuppressive drug nor an anticoagulant.…”