Mucormycosis Resulting in Gastric Perforation in a Patient with Acute Myelogenous Leukemia: Report of a Case

Song, Kyo Young; Kang, Won Kyung; Park, Chong Won; Choi, Yeong Jin; Rha, Sung Eun; Park, Cho Hyun

doi:10.1007/s00595-006-3246-1

Cited by 14 publications

(9 citation statements)

References 22 publications

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“…Rapid diagnosis followed by aggressive therapy, including urgent surgery and intravenous amphotericin B are the critical components of optimal treatment. However, mortality remains high despite aggressive treatment, with reported rates up to 48% in SOT recipients and 75% in HSCT patients …”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal mucormycosis in immunocompromised hosts

Dioverti

Cawcutt

Abidi

et al. 2015

Mycoses

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Invasive mucormycosis is a rare fungal infection in immunocompromised hosts, but it carries a high mortality rate. Primary gastrointestinal disease is the least frequent form of presentation. Early diagnosis and treatment are critical in the management; however, symptoms are typically non-specific in gastrointestinal disease, leading to delayed therapy. To describe the clinical presentation, diagnosis, treatment and outcomes of gastrointestinal mucormycosis in immunocompromised hosts, we reviewed all cases of primary gastrointestinal mucormycosis in immunocompromised hosts reported in English literature as well as in our Institution from January 1st 1991 to December 31st 2013 for a total of 31 patients. About 52% of patients underwent solid organ transplant (SOT), while the rest had an underlying haematologic malignancy. Abdominal pain was the most common presenting symptom, followed by gastrointestinal bleeding and fever. Gastric disease was more common in SOT, whereas those with haematologic malignancy presented with intestinal disease (P = 0.002). Although gastrointestinal mucormycosis remains an uncommon condition in immunocompromised hosts, it carries significant morbidity and mortality, particularly in cases with intestinal involvement. A high index of suspicion is of utmost importance to institute early and appropriate therapy and improve outcomes.

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Section: Introductionmentioning

confidence: 99%

Gastrointestinal mucormycosis in immunocompromised hosts

Dioverti

Cawcutt

Abidi

et al. 2015

Mycoses

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“…Additionally the use of non- Mucorales active, antifungal prophylaxis predisposes patients to invasive fungal disease [4]. Mortality rates of up to 75% are reported in HSCT patients despite aggressive therapy [6], [7]. Management of GI mucormycosis consists of reversal of underlying predisposing risk factors if possible, surgical debridement, and effective anti-fungal treatment [1], [4].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment traditionally consists of surgery and liposomal intravenous amphotericin B. Posaconazole, an azole with activity against some mucorales species has also been utilized often in combination with amphotericin B and surgery [4], [5]. Despite aggressive treatment regimens, mortality rates remain high in stem cell transplant patients with reported rates at 75% [6], [7]. We present a case of invasive gastrointestinal mucormycosis in an immunocompromised host treated with systemic and topical anti-mold therapy.…”

Section: Introductionmentioning

confidence: 99%

Combination liposomal amphotericin B, posaconazole and oral amphotericin B for treatment of gastrointestinal Mucorales in an immunocompromised patient

Anderson

McManus

Perreault

et al. 2017

Medical Mycology Case Reports

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Mucormycosis is a life threatening infection caused by fungi in the order Mucorales. Mucormycosis can affect any organ system with rhino-orbital-cerebral and pulmonary infections being the most predominant infection types. Gastrointestinal mucormycosis is rare and accounts for only 4–7% of all cases. Here, we present a case of invasive gastrointestinal mucormycosis in an immunocompromised host treated with systemic and topical anti-mold therapy.

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“…However, our case showed an unusually long segmental absence of the bowel wall, which was caused by extensive haemorrhagic infarction and perforation caused by mucormycosis. In 2006, Song et al [5] reported a case of mucormycosis resulting in gastric perforation in a patient with acute myelogenous leukaemia. In that case, CT showed a long segmental absence of posterior wall of the gastric fundus with a massive collection of haematoma, which is very similar to our case.…”

Section: Discussionmentioning

confidence: 99%

A patient with neutropenic fever and abdominal pain showing absent bowel wall on CT

Kim

Rha

Kang

2011

BJR

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A 35-year-old Asian female with acute myeloblastic leukaemia developed fever and right lower abdominal pain 6 days after second induction chemotherapy. The white blood cell count was 10 ml 21 with 0% neutrophils. Peripheral blood culture was negative for aerobic and anaerobic organisms. Haematologists changed the antibiotics and started amphotericin B on the presumptive diagnosis of typhlitis. However, 13 days later, the patient again complained of severe abdominal pain. An urgent contrast enhanced abdominal CT was performed.CT showed a long segmental wall thickening of the terminal ileum, caecum and ascending colon with targetlike appearance. A relatively long segment of posteromedial wall of the ascending colon was not visualised, in association with a small amount of concentrated air bubbles close to the bowel wall, regional mesenteric haziness and a large amount of loculated fluid collected along the right psoas muscle (Figure 1-4).What is the cause of these imaging findings?

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Mucormycosis Resulting in Gastric Perforation in a Patient with Acute Myelogenous Leukemia: Report of a Case

Cited by 14 publications

References 22 publications

Gastrointestinal mucormycosis in immunocompromised hosts

Gastrointestinal mucormycosis in immunocompromised hosts

Combination liposomal amphotericin B, posaconazole and oral amphotericin B for treatment of gastrointestinal Mucorales in an immunocompromised patient

A patient with neutropenic fever and abdominal pain showing absent bowel wall on CT

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