Purpose: A 48-year-old Hispanic man developed melena after 25 days of hospitalization. He was initially admitted following motor vehicle accident that resulted in hemopneumothorax, multiple fractures, and blunt abdominal trauma. No past medical history was reported. After endotracheal intubation and chest tubes placement, he underwent splenectomy and small bowel resection. He was then transferred to the ICU, developed septic shock requiring antibiotics, vasopressors, and corticosteroids. Repeated laparotomy on day 9 revealed bowel perforation, requiring new resection and ileostomy. His course was complicated by uncontrolled hyperglycemia, requiring high doses of insulin. After clinical improvement and placement of tracheostomy, he was transferred out of the ICU on day 24, and melena was noticed the day after. He was tachycardic, afebrile and normotensive. Surgical wound was clean and abdominal exam revealed diffuse tenderness. Upper endoscopy showed friable stomach mucosa, with a large exudative ulceration in the gastric body from where biopsy was taken, and other scattered clean based ulcers in antrum and fundus. Esophagus and duodenum were normal. Histopathology revealed necroinflammatory exudate with marked inflammation and broad aseptate fungal hyphae with right angle branching consistent with gastric mucormycosis. Liposomal amphotericin B and micafungin were started. He has recovered after a month of therapy with no recurrence of bleeding. Gastrointestinal mucormycosis is rare, with about 100 cases reported and mortality rate close to 85%. Risk factors include steroid use, hematologic malignancies and diabetes. It most commonly affects the stomach (58%), followed by the colon (32%) and ileum (7%). Clinical manifestations include mass, gastrointestinal bleeding and perforation. Diagnosis relies in histological findings of fungal organisms consistent with the disease. Emergence of healthcare-associated mucormycosis (HCM) has been seen in the last 40 years, as transplants, cancer and diabetes, have become more common. Infection portal of entry includes surgery and use of medical devices. In summary, different risk factors, including multiple abdominal surgeries, short term steroids, and uncontrolled hyperglycemia, played a role in the pathogenesis of gastric HCM in our patient.Figure