Gitali Bhagawati1*, Mahesh Gupta2, Sania Paul1, Rekha Saji Kumar1 and Lincy3
1Gastric Mucormycosis by Rhizopus microsporus in a Patient with Uncontrolled Diabetes Mellitus
2Department of Gastroenterology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
3Department of Infection Control, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India
*Corresponding Author: Gitali Bhagawati, Department of Microbiology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India.
Received: April 26, 2021 ; Published: May 17, 2021
Mucormycosis is a rapidly progressive life-threatening angio-invasive fungal infection caused by ubiquitous filamentous fungi of the order Mucorales and class Zygomycetes. The disease spectrum ranges from involvement of sinuses, lung, brain and skin to disseminated fatal infections, especially in immunocompromised hosts. Cases of primary gastric mucormycosis are rare in literature. It can be lethal due to invasion of gastric mucosa by Mucorales. High index of clinical suspicion in patient coming with haematemesis and melena with immunocompromised status can help in early intervention. Common risk factor for gastrointestinal mucormycosis (GIM) has been found to be uncontrolled DM with and without diabetic ketoacidosis (DKA). Here, we are presenting a case of 48 year male patient diagnosed with mucormycosis of gastric fundus coming with history of melena of one week duration and single episode of haematemesis. The patient had uncontrolled DM and was on oral hypoglycemic agent. Fungal culture showed growth of Mucor. Morphology of the fungal colonies as well as microscopic examination of the fungus confirmed it as Rhizopus spp. Fungal colonies were sent for further confirmation by molecular sequencing to reference laboratory. Species level identification was done by ITS1-5.8S-ITS2 rRNA gene cluster internal transcribed spacer [ITS] sequencing. Sequencing confirmed the fungus as Rhizopus microsporus. The patient was put on intravenous Amphotericin-B; but was stopped in view of renal function derangement. Later Posaconazole was added and patient responded completely.
Keywords: Zygomycetes; Rhizopus microspores; Gastrointestinal Mucormycosis; Immunocompromised
Citation: Gitali Bhagawati., et al. “Gastric Mucormycosis by Rhizopus microsporus in a Patient with Uncontrolled Diabetes Mellitus”. Acta Scientific Microbiology 4.6 (2021): 40-44.
Copyright: © 2021 Gitali Bhagawati., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.