Julio Alvarado-Lezama1, Omar Espinosa-González2, Eugenio García-Cano2, Gabriela Sánchez-Córdova2. 1. Servicio de Cirugía General, Unidad Médica de Alta Especialidad, Manuel Ávila Camacho, IMSS Puebla, Puebla, México. Electronic address: surgery_allez@yahoo.com.mx. 2. Servicio de Cirugía General, Unidad Médica de Alta Especialidad, Manuel Ávila Camacho, IMSS Puebla, Puebla, México.
Abstract
BACKGROUND: Mucormycosis is a rare fungal infection of the mucorales order, which affects mostly immunocompromised patients. The association with emphysematous gastritis is rare and often fatal produced by gas -forming bacteria. We report the case of a trauma patient with type 1 diabetes mellitus, and diabetic ketoacidosis complicated with gastric mucormycosis associated with emphysematous gastritis. CLINICAL CASE: A male aged 32 who is involved in a car accident, who suffered head trauma, is admitted to the Intensive Care Unit, presenting diabetic ketoacidosis and upper gastrointestinal bleeding. An endoscopy was performed and an erosive esophagitis Class C, ischemia and gastric necrosis was found. A computed tomography scan showed emphysematous gastritis and gastric necrosis. He underwent total gastrectomy with a histopathology report of gastric mucormycosis. After the surgical procedure the patient died because of sepsis secondary to pulmonary mucormycosis DISCUSSION: Mucormycosis is a rare fungical disease which infrequently affects the gastrointestinal tract, being the stomach the most affected site. The mortality is high if the diagnosis is not done promptly and appropriate treatment is given. CONCLUSION: Suspecting its existence is necessary in patients with immunocompromised status to diagnose and provide timely treatment to increase survival, because of its high mortality.
BACKGROUND:Mucormycosis is a rare fungal infection of the mucorales order, which affects mostly immunocompromised patients. The association with emphysematous gastritis is rare and often fatal produced by gas -forming bacteria. We report the case of a traumapatient with type 1 diabetes mellitus, and diabetic ketoacidosis complicated with gastric mucormycosis associated with emphysematous gastritis. CLINICAL CASE: A male aged 32 who is involved in a car accident, who suffered head trauma, is admitted to the Intensive Care Unit, presenting diabetic ketoacidosis and upper gastrointestinal bleeding. An endoscopy was performed and an erosive esophagitis Class C, ischemia and gastric necrosis was found. A computed tomography scan showed emphysematous gastritis and gastric necrosis. He underwent total gastrectomy with a histopathology report of gastric mucormycosis. After the surgical procedure the patient died because of sepsis secondary to pulmonary mucormycosis DISCUSSION: Mucormycosis is a rare fungical disease which infrequently affects the gastrointestinal tract, being the stomach the most affected site. The mortality is high if the diagnosis is not done promptly and appropriate treatment is given. CONCLUSION: Suspecting its existence is necessary in patients with immunocompromised status to diagnose and provide timely treatment to increase survival, because of its high mortality.
Authors: Salah Termos; Feras Othman; Mohammad Alali; Bader M S Al Bader; Talal Alkhadher; Wael Fathi Hassanaiah; Ali Taqi; Abhijit Sapkal Journal: Am J Case Rep Date: 2018-05-04