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

Abdi Bati Wotiye,Poornachandra Ks,Biniyam Alemayehu Ayele

doi:10.1186/s12876-020-01202-5

Abdi Bati Wotiye, Poornachandra Ks + Show 1 more

Open Access

https://doi.org/10.1186/s12876-020-01202-5

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Abstract

BackgroundMucormycosis 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 presentationWe 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.ConclusionThis 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.

Highlights

ConclusionThis 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
It’s important to consider intestinal mucormycosis even in patients who are immunocompetent without traditional risk factors
Very few cases of gastrointestinal mucormycosis in an immunocompetent host have been reported [5, 6]. The aim of this case report is to highlight the importance of early detection and aggressive medical management of invasive mucormycosis may result in good outcome

Summary

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. It’s important to consider intestinal mucormycosis even in patients who are immunocompetent without traditional risk factors

Background

Results

Discussion and conclusion