Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Infect Dis. Feb 25, 2018; 8(1): 1-3
Published online Feb 25, 2018. doi: 10.5495/wjcid.v8.i1.1
Gastric mucormycosis: A case report
Mpho Klaas Kgomo, Ali Ahmed Elnagar, Kgataki Mashoshoe, P Thomas, W G Van Hougenhouck-Tulleken
Mpho Klaas Kgomo, Ali Ahmed Elnagar, Kgataki Mashoshoe, P Thomas, W G Van Hougenhouck-Tulleken, Department of Gastroenterology, University of Pretoria, Pretoria 0001, Gauteng Province, South Africa
Author contributions: Kgomo MK was involved in the write-up and submission of the case report, patient care and interpretation of the literature; Elnagar AA, Mashoshoe K, Thomas P and Van Hougenhouck-Tulleken WG was involved in the collection of data, patient care and interpretation of test results.
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: Dr. Kgomo has nothing to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mpho Klaas Kgomo, Professor, Department of Gastroenterology, University of Pretoria, Bophelo Street, Gezina, Pretoria 0001, Gauteng Province, South Africa. mpho.kgomo@up.ac.za
Telephone: +27-12-3542246 Fax: +27-12-3220696
Received: September 14, 2017
Peer-review started: September 16, 2017
First decision: October 23, 2017
Revised: November 9, 2017
Accepted: November 27, 2017
Article in press: November 27, 2017
Published online: February 25, 2018
Processing time: 97 Days and 23.8 Hours
ARTICLE HIGHLIGHTS
Case characteristics

We present a 38 years old female seen in our hospital with a 2 wk history of productive cough dyspnoea and lethargy.

Clinical diagnosis

On clinical examination she had oral thrush, more than 1 cm cervical and axillary lymphadenopathy, pallor with an ejection systolic murmur, hypotension, tachycardia and respiratory failure.

Differential diagnosis

Differential diagnosis of human immunodeficiency virus infection with candidiasis, TB pneumonia and gastrointestinal bleed was made.

Laboratory diagnosis

She was found to have severe anemia, acquired immune deficiency syndrome with pneumonia, esophageal candidiasis and gastric mucormycosis and gastric bleed.

Imaging diagnosis

CXR showed multi-lobar pneumonia and gastroscopy showed gastric plaques as shown in Figure 1.

Pathological diagnosis

Gastric biopsy showed fungal hyphae consistent with mucormycosis as shown in Figure 2.

Treatment

She was started on anti-tuberculosis treatment, fluconazole broad spectrum antibiotics followed a few days later by amphotericin B.

Related reports

She failed to respond to fluconazole and only responded to amphotericin B.

Term explanation

Mucormycosis is an invasive fungal infection seen only in patients with reduced immune system.

Experiences and lessons

Mucormycosis infect the stomach and can co-exist with candida.