A Case of Gastric Ulcer Associated with Mucormycosis

Kang, Jin Kyung; Park, In Suh; Kim, Se Kyu; Song, Si Young; Park, Chan Il; Lee, Don Haeng; Kwon, Kun Ho; Lee, Sang Yup

Abstract

Mucormycosis is an uncommon, frequently fatal, opportunistic fungal infection. Rhinocerebral and pulmonary involvement are the most common forms and usually occur in immunecompromised patients. Gastrointestinal involvement is extremely rare, the stomach being the most frequently involved site among them. When gastric mucormycosis presents as an invasive fungal infection the prognosis is extremely poor. Alternatively when the fungus may colonize the gastric mucosa without invasion of the blood vessels, the prognosis is good. Early diagnosis and tirnely institution of aggressive treatment is essential for the patients with mucormycosis. We report a 72-year-old man of gastric mucormycosis confirmed by histologic examination of endoscopic biopsy specimen. The patient was admitted. to intensive care unit under the diagnosis of adult respiratory distress syndrome and sepsis. He has been suffered from 5 years of end stage renal disease and 4 months of pulmonary tuberculosis and managed by continuous ambulatory peritoneai dialysis and anti-tubereulosis medications. On the 5th hospital day, esophagogastroduodenoscopy was underwent to remove the pieces of thermometer accidentaly broken, which revealed the 1.0 cm ulcerative lesion on the posterior wall of the upper body of stomach. The base of ulcer was coated with whitish-yellow dirty exudates and slightly irregular and the margin was nodular. The mucosae were friable and easily bled with light touch. The histologic examination of biopsy specimen revealed the multiple non-septated fungal hyphae branching right-angle.