Gastrointestinal Mucormycosis: A Clinical Review

Abstract

Mucormycosis is a devastating fungal infection that is usually seen in immunocompromised hosts. It is caused by fungi of the subphylum Mucoromycotina, order Mucorales, with most cases caused by Mucor, Rhizopus, or Rhizomucor species. It can involve any organ system and can disseminate in severe cases. Lately, there has been an increased number of reports for mucormycosis infection in immunocompetent patients. Gastrointestinal system involvement is rare compared to other organ systems but has been increasingly reported in the literature. Mucormycosis can affect any part of the gastrointestinal tract and lead to different presentations depending on the area of involvement. Due to the paucity of the condition, there has been no specific guidelines on how to treat gastrointestinal mucormycosis. In this review, we discuss the risk factors of gastrointestinal mucormycosis, clinical presentation, approach to diagnosis, and most recent treatment modalities for gastrointestinal mucormycosis.

Keywords: Clinical presentation; Diagnosis; Gastrointestinal mucormycosis; Risk factors; Treatment.

Figure 1

Cecal biopsy. Large, non-septate fungal organisms consistent with Mucorales (Mucor/Rhizopus) in a background of ulceration and acute inflammation (arrowhead). The presence of fungal organisms in the ulcer bed is most likely indicative of infection.

Figure 2

Fungal culture. Rapidly growing white fluffy colony that overfills agar plate on the Sabouraud dextrose agar (SDA) (a), and almost completely filling the potato dextrose agar (PDA) (b). A lactophenol cotton blue (LCB) preparation (c, d) showing wide hyphae, rare septations, branched sporangiophores, with round sporangia (sac-like structure). (d) Seen in the background are some spores of ruptured sporangium.