Indian Journal of Critical Care Case Report

Register      Login

VOLUME 3 , ISSUE 6 ( November-December, 2024 ) > List of Articles

CASE REPORT

A Rare Presentation of Abdominal Mucormycosis with Gastric Perforation and Splenic Infarction: A Case Report and Review of Literature

Kajal Arora, Bhuvana Krishna, Arun Kumar

Keywords : Case report, Gastric perforation, Mucormycosis, Splenic infarction

Citation Information : Arora K, Krishna B, Kumar A. A Rare Presentation of Abdominal Mucormycosis with Gastric Perforation and Splenic Infarction: A Case Report and Review of Literature. 2024; 3 (6):172-175.

DOI: 10.5005/jp-journals-11006-0138

License: CC BY-NC 4.0

Published Online: 19-10-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim and background: Mucormycosis is a rare and often fatal opportunistic illness that is more common in immunocompromised patients. Involvement of the gastrointestinal tract is uncommon, accounting for only 7% of all reported cases. Here, we present an unusual manifestation with gastric perforation and splenic infarction due to a splenic artery mycotic thrombus, along with a literature review. Case description: A 40-year-old female with poorly controlled diabetes mellitus presented with acute decompensated heart failure and diabetic ketoacidosis. During her course, she had a significant hemoglobin drop and was diagnosed with multiple necrotic gastric ulcerations with subsequent gastric perforation and splenic infarction. We searched the PubMed and Embase databases with the terms: (splenic infarction) AND (gastric perforation) AND (mucormycosis) till May 2024. To date, six cases have been reported of combined gastric and splenic involvement by mucormycosis. Most of the patients had an underlying immunosuppressive state. Despite combined medical and surgical treatment modalities, only 17% survived the illness. The most common presentation was necrotic ulceration. Conclusion: Due to the disease's rarity, the precise diagnosis of gastric mucormycosis may be delayed. Diligent clinical insight is required for the early diagnosis and management of the disease, especially in immunocompromised patients. Radiological imaging modalities, such as computed tomography (CT) scans or magnetic resonance imaging of the abdomen, generally demonstrate non-specific findings. Additional testing involving endoscopic or surgical biopsies of the lesions is necessary for rapid diagnosis. Clinical significance: The early diagnosis and timely initiation of antifungal therapy can be beneficial in halting the fulminant course of gastrointestinal mucormycosis.


PDF Share
  1. Chakrabarti A, Singh R. Mucormycosis in India: unique features. Mycoses 2014;57(Suppl 3):85–90. DOI: 10.1111/myc.12243
  2. Kaur H, Ghosh A, Rudramurthy SM, et al. Gastrointestinal mucormycosis in apparently immunocompetent hosts-a review. Mycoses 2018;61(12):898–908. DOI: 10.1111/myc.12798
  3. Tinmouth J, Baker J, Gardiner G. Gastrointestinal mucormycosis in a renal transplant patient. Can J Gastroenterol 2001;15(4):269–271. DOI: 10.1155/2001/237384
  4. Islam J, Thomson SR, Tudor G, et al. Ileosigmoid knot complicated by gastric and splenic mucormycosis: a lethal combination. BMJ Case Rep 2009;2009:bcr10.2008.1049. DOI: 10.1136/bcr.10.2008.1049
  5. Cañete-Gómez J, Segura-Sampedro JJ, Reguera-Rosal J. An unusual cause of pneumoperitoneum. Gastroenterology 2014;147(5):e3–e5. DOI: 10.1053/j.gastro.2014.05.041
  6. Enani MA, Alharthi BN, Dewanjee N, et al. Spontaneous gastric ulcer perforation and acute spleen infarction caused by invasive gastric and splenic mucormycosis. J Glob Infect Dis 2014;6(3):122–124. DOI: 10.4103/0974-777X.138509
  7. Hammami F, Koubaa M, Chakroun A, et al. Survival of an immuno-competent patient from splenic and gastric mucormycosis-case report and review of the literature. J Mycol Med 2021;31(4):101174. DOI: 10.1016/j.mycmed.2021.101174
  8. Yuvaraj M, Mathapati PM, Seena CR, et al. Gastric mucormycosis with splenic invasion a rare abdominal complication of COVID-19 pneumonia. J Clin Imaging Sci 2021;11:62. DOI: 10.25259/JCIS_161_2021
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.