Abstract
Gastrointestinal (GI) mucormycosis is a rare and life-threatening invasive fungal infection. GI mucormycosis occur in all parts of the alimentary tract, with the stomach being the most common site. Diabetes mellitus and other types of conditions associated with immunodeficiency, including hematologic malignancies, solid organ transplantation and glucocorticoid therapy, are risk factors for GI mucormycosis. There are few studies reporting cases of gastric mucormycosis in patients with liver cirrhosis, and even fewer reporting the successful treatment of invasive gastric mucormycosis in a patient with liver cirrhosis. This study presents a case of invasive gastric mucormycosis in a patient with liver cirrhosis, which was treated successfully by prompt diagnosis, metabolic support, surgical debridement of involved tissues and antifungal therapy.
Highlights
Mucormycosis is a rare and life‐threatening invasive fungal infection caused by fungi of the Zygomycetes class and Mucorales order
GI mucormycosis occurs more frequently in patients with diabetes mellitus and other conditions associated with immunodeficiency, including hematologic malignancies, solid organ transplantation, glucocorticoid therapy, chronic renal failure, liver cirrhosis and malnutrition in infants and children [6,7,8]
Mucormycosis is an uncommon type of fungal infection, most frequently occurring in immunocompromised patients and those with diabetes mellitus [1]
Summary
A 55‐year‐old male with alcoholic liver cirrhosis was referred to the emergency department of Keimyung University Dongsan Medical Center (Daegu, Republic of Korea) from a local hospital, complaining of severe, constant pain throughout the whole abdomen for 6 h. The surgical findings showed an unusually large perforation, measuring 5.0x3.7 cm in gastric angle (Fig. 2), with ~2,000 ml ascitic fluid collection in the abdominal cavity which was not bloody. A subtotal gastrectomy and gastrojejunostomy with massive irrigation in the abdominal cavity was LEE et al: TREATMENT OF INVASIVE GASTRIC MUCORMYCOSIS IN A PATIENT WITH LIVER CIRRHOSIS performed. On the seventh day in hospital, the pathologic diagnosis was confirmed as invasive gastric mucormycosis (Fig. 3). All vital signs and laboratory data were normal and the patient was in a satisfactory condition without antifungal treatment.
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