CT appearance of gastrointestinal tract mucormycosis

Ghuman, Samarjit Singh; Sindhu, Pendyala; Buxi, T. B. S.; Sheth, Swapnil; Yadav, Anurag; Rawat, Kishan Singh; Sud, Seema

doi:10.1007/s00261-020-02854-3

Cited by 16 publications

(13 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This amplifies the risk of a possible cutaneous manifestation of mucormycosis. Malnutrition and solid organ transplantation put the individuals at the risk of developing gastrointestinal (GI) mucormycosis in the bowel and the GI tract, specifically the intestines [34,44]. However, the rapid disease progression and the lack of clear clinical signs besides fever delay differential diagnosis from GI diseases [38].…”

Section: Disseminated Mucormycosismentioning

confidence: 99%

“…However, the rapid disease progression and the lack of clear clinical signs besides fever delay differential diagnosis from GI diseases [38]. CT scans of isolated cases of GI tract, colonic, and small bowel mucormycosis reveal dilatation of the wall, bleeding, and mass thickening [44]. A rare case of GI mucor in COVID-19 patients confirmed the signs and additionally presented with abdominal tenderness, and bilateral ulceration [45].…”

Section: Disseminated Mucormycosismentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 Associated Mucormycosis: A Systematic Review from Diagnostic Challenges to Management

et al. 2021

View full text Add to dashboard Cite

The coronavirus disease 2019 (COVID-19) outbreak has caused significant destruction, claiming over three million lives worldwide. Post SARS-COV-2 invasion, immunosuppression with hyperglycemia and elevated ferritin levels along with steroidal treatment creates a perfect storm for opportunistic infections. There is increasing evidence of mucormycosis co-infection in COVID-19 patients, during or post-treatment. A worse prognosis, a late diagnosis, and limited guidelines of screening and management of COVID-19 associated mucormycosis have made healthcare professionals fear an epidemic alongside a pandemic. This review geographically reports cases of COVID-19 associated mucormycosis (CAM), evaluates characteristics, clinical manifestations, and outcomes of mucormycosis in COVID-19 active or recovered patients. It further describes preventive strategies and recommendations for optimal management therapy that can be adopted worldwide to curtail an impending threat to the healthcare system.

show abstract

Section: Disseminated Mucormycosismentioning

confidence: 99%

Section: Disseminated Mucormycosismentioning

confidence: 99%

COVID-19 Associated Mucormycosis: A Systematic Review from Diagnostic Challenges to Management

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Due to its high mortality, rapid diagnosis and treatment are essential. Imaging findings in the appropriate context may be suggestive - in small bowel mucormycosis, as in our case, the findings are those of multifocal ischemia [ 9 ]. However, the mainstay of diagnosis remains the histopathological examination of biopsy specimens, with or without polymerase chain reaction (PCR), which classically shows non-septate hyphae branching at right angles [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Intestinal Perforation Secondary to Mucormycosis Associated With Puerperal Sepsis

Bhat¹,

Anitha²,

Thomas³

et al. 2021

Cureus

View full text Add to dashboard Cite

Mucormycosis is a rare opportunistic infection, usually seen in diabetics, immunocompromised, or those with coronavirus disease 2019 (COVID-19). Gastrointestinal involvement is uncommon but often deadly. We report a case of gastrointestinal mucormycosis causing intestinal perforation in a non-diabetic, COVID-19 negative, immunocompetent woman, associated with puerperal sepsis. A 22-year-old woman presented to our center on post-natal day five, following delivery with insertion of an intrauterine contraceptive device (IUCD). She had complaints of breathlessness, fatigue, and giddiness. Examination revealed tachycardia, tachypnea, hypotension, and bilateral pedal edema. Following appropriate investigations, she was diagnosed with puerperal sepsis with pre-renal acute kidney injury. Imaging was suggestive of retained products of conception, and she subsequently underwent dilation and evacuation (D&E) on day eight of admission. Following brief symptomatic improvement, on day 10 of admission, she developed vomiting, abdominal distension, and pain, with obstipation. Erect X-ray showed air under the diaphragm, suggestive of perforation. She emergently underwent laparotomy with limited right hemicolectomy, ileostomy with mucous fistula. Intraoperative findings revealed a closed-loop obstruction involving terminal ileum, with two perforations. The biopsy report later revealed colonization of Mucor and hemorrhagic necrosis along the entire length of the resected specimen. She was started on amphotericin B, and after a slow recovery, was discharged. Gastrointestinal mucormycosis is rare and has a mortality rate of 94%. It is usually seen in those with predisposing factors for mucormycosis. This is the first report of mucormycosis associated with puerperal sepsis. It is typically acquired via ingestion and may cause perforation, where mortality is further increased. Diagnosis can only be confirmed by histopathology demonstrating the characteristic morphology of Mucor. Treatment requires resection of necrotic tissues, intensive treatment with amphotericin B, and correction of predisposing factors. Our case highlights the need for a high degree of suspicion for mucormycosis in patients with intestinal perforation, even if immunocompetent, and its potential association with puerperal sepsis.

show abstract

“…Along with the presence of the above-mentioned risk factors, worsening clinical symptoms in spite of broad-spectrum antibiotics and repeated sterile culture of body fluids (like urine and blood) should raise the suspicion of fungal infection [ 8 ]. Contrast-enhanced axial imaging of the abdomen can detect indirect signs of mucormycosis like pneumatosis, ischemia, and/or infarction with a lack of any obvious vascular thrombosis [ 9 ]. In our case, we could not perform a contrast-enhanced CT scan as he had a deranged renal function test which delayed the diagnosis of mesenteric ischemia.…”

Section: Discussionmentioning

confidence: 99%

Synchronous Small Bowel Gangrene With Pyelonephritis Secondary to Mucormycosis: A Disastrous Complication of COVID-19 Pandemic

Varshney¹,

Swami²,

Thirunavukkarasu³

et al. 2021

Cureus

View full text Add to dashboard Cite

Mucormycosis is a rare infection caused by fungi of the order Mucorales. The infection frequently involves the rhino-cerebral or respiratory system and involvement of the gastrointestinal (GI) tract and kidney are rare. It usually infects immunocompromised individuals due to various causes and an upsurge is hypothesized to be linked with irrational use of steroids during coronavirus disease 2019 (COVID-19) pandemic.We encountered a rare case of systemic mucormycosis that involved both renal as well as mesenteric vessels and led to ischemia of both vital organs. The patient developed massive bowel gangrene involving the duodenum, proximal jejunum, and left kidney due to angioinvasive mucormycosis.The diagnosis of GI mucormycosis may further increase during the current pandemic. The physicians, as well as surgeons, should be aware of this unwanted complication and keep a high index of suspicion for this rare disease.

show abstract

CT appearance of gastrointestinal tract mucormycosis

Cited by 16 publications

References 38 publications

COVID-19 Associated Mucormycosis: A Systematic Review from Diagnostic Challenges to Management

COVID-19 Associated Mucormycosis: A Systematic Review from Diagnostic Challenges to Management

Intestinal Perforation Secondary to Mucormycosis Associated With Puerperal Sepsis

Synchronous Small Bowel Gangrene With Pyelonephritis Secondary to Mucormycosis: A Disastrous Complication of COVID-19 Pandemic

Contact Info

Product

Resources

About