Fatal invasive gastric mucormycosis: Two case reports

• Published in: Clinical case reports Vol. 10; no. 9; pp. e6330 - n/a
• Main Authors: Khsiba, Amal, Moalla, Manel, Nechi, Salwa, Bani, Amina, Elloumi, Aicha, Jemal, Sana, Azouz, Mohamed Moussaddek, Medhioub, Mouna, Hamzaoui, Lamine
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-09-2022; John Wiley and Sons Inc; Wiley
• Subjects: Abdomen; Alcoholism; Ascites; Blood pressure; Cancer; Case Report; Case reports; Conflicts of interest; Consent; Creatinine; Debridement; Diabetes; Endoscopy; Fever; fungal infection; Fungal infections; gastric; Gastrointestinal surgery; Hemoglobin; Infections; Laboratories; Medical prognosis; Mortality; mucormycosis; Patients; Sepsis; Stomach; Ulcers; Vomiting; fungal infection; gastric; diabetes; mucormycosis
• ISSN: 2050-0904; 2050-0904
• DOI: 10.1002/ccr3.6330

Mucormycosis is a fungal infection affecting most commonly immunocompromised patients. Hereby, we report two cases: the first one is about a 61‐year‐old female with diabetes who presented with vomiting. The upper gastrointestinal endoscopy showed a budding grayish process which corresponded to an invasive mucormycosis in histology. As laboratory tests showed renal dysfunction, conventional amphotericin B was started at low doses since liposomal form was unavailable in Tunisia. Evolution was marked by a worsening of renal function leading to drug therapy withdrawal. Total gastrectomy was delayed because of a pulmonary embolism and was practiced 2 months later. The patient passed away 10 days after surgery. The second patient was a 59‐year‐old man who presented with vomiting and fast worsening of general state. At admission, he had a septic shock. Explorations revealed an invasive gastric mucormycosis. He died few days after admission. Thus, prompt diagnosis of mucormycosis and rapid initiation of treatment based on amphotericin B and surgical debridement is necessary to improve prognosis.