Three Cases of Gastrointestinal Mucor Colonization in Patients With Prolonged Neutropenia

Abstract

Abstract Mucor is a well-known opportunistic organism; however, it rarely infects the gastrointestinal (GI) tract. Although known to transiently colonize healthy immunocompetent individuals, the incidence of mucormycosis is increasing in patients with hematologic malignancies, which can have serious consequences in an immunocompromised host. This abstract presents 3 patients from a single institution with Mucor colonization of their stool. Each patient had a hematologic malignancy and was neutropenic when diagnosed with Mucor colonization of the stool. The duration of neutropenia ranged from 1 to 76 days with median of 31 days at the time of diagnosis. Patients were observed for symptoms of GI tract invasion, and they received antimold prophylaxis while neutropenic. Despite GI shedding, no mold sinusitis or pneumonia or gastroenteritis was noted. Gastrointestinal mucormycosis was never noted during their hospital course. This case series emphasizes the importance of not dismissing mold colonization of the stool in a patient with prolonged neutropenia who is at high risk of invasive GI tract mucormycosis. When stool cultures grow Mucor in patients with prolonged neutropenia, anti-Mucor therapy is indicated and may prevent invasive mold infection during the period of risk.