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• W2920971521 abstract "Purpose: A 60-year-old male veteran presented to our facility with confusion and hypoxia. He was endotracheally intubated and treated for severe community acquired pneumonia in the intensive care unit. After extubation, he began complaining of epigastric pain. Our service was consulted for endoscopy. On our evaluation, he was awake and appropriately communicative. His past medical history included depression and hypertension. He did not have diabetes. On physical examination, his vital signs were within normal limits. His abdomen was soft with mild tenderness to deep palpation in the epigastrum. Lab values were significant for hemoglobin of 8.9 g/dL. He was scheduled for an upper endoscopy. Examination of the esophagus and duodenum were unremarkable. Upon entering the stomach, a large ulcer was encountered. It began at the cardia and traveled along the lesser curve into the antrum, encompassing fifty percent of the lumen. There was thick, green exudate overlying the ulcer bed that was not able to be washed off. Biopsies were obtained from the margin of the ulcer, the ulcer bed, and samples of the exudates were obtained and sent for pathology. Histologic examination of the samples showed granulomatous gastritis with numerous fungal organisms consistent with mucormycosis. The patient was started on AmBisome® and Micafungin. A CAT scan of the sinuses showed no evidence of mucormycosis in the sinuses. A CAT scan of the abdomen and pelvis showed thickening of the wall of the gastric body, but was otherwise normal. Antibodies to HIV-1 and HIV-2 were negative. There was no evidence of hematologic malignancy on evaluation of the peripheral smear. After the abdominal pain had resolved, he was discharged home in stable condition with plans to repeat an upper endoscopy in 8 weeks and to follow up with the infectious disease physicians. Mucormycosis is a rare entity described predominantly in immunosupressed patients. Patients with hematologic malignancies, solid organ and bone marrow transplant recipients, and type 1 and 2 diabetics are at the highest risk. Most commonly, this fungus will cause disease isolated to the sinuses, lungs, or skin. In a review of 929 cases of mucomycosis, only 7% had gastrointestinal involvement. These patients had a mortality of 85%. In that same review, only 19% of those patients had no immunocompromised state and only 9% of those patients had GI involvement. In summary, our case represents a rare manifestation of a potentially deadly disease in a remarkably asymptomatic immunocompetent host." @default.
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• W2920971521 date "2010-10-01" @default.
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• W2920971521 title "Isolated Gastric Mucormycosis - A Rare Cause of a Large Gastric Ulceration in an Immunocompetent Host" @default.
• W2920971521 doi "https://doi.org/10.14309/00000434-201010001-00472" @default.
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