Mucormycosis causing massive lower gastrointestinal bleeding: a case report

Ting Hsuan Chiang, Yi Wei Lee, Jui Hsiang Tan, Chih Chin Kao, Chun Chao Chang, Kuan Chieh Fang

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: Lower gastrointestinal bleeding (LGIB) is very common in the hospital setting. Most bleedings stop spontaneously, but rare infectious causes of LGIB may lead to rapid and serious complications if left untreated and are sometimes very difficult to diagnose preoperatively. Case presentation: We described a young man with poorly controlled Type I diabetes mellitus and chronic alcohol abuse who presented with acute altered mental status. During his hospitalization for treatment of diabetic ketoacidosis, acute renal failure, and sepsis, he suddenly developed massive hematochezia of 1500 mL. Colonoscopy was performed and a deep ulcer covered with mucus with peripheral elevation was noted at the transverse colon. Biopsy of the ulcer later revealed nonpigmented, wide (5–20 µm in diameter), thin-walled, ribbon-like hyphae with few septations and right-angle branching suggestive of mucormycosis demonstrated by Periodic acid–Schiff stain. He received 2 months of antifungal treatment. Follow up colonoscopy post-treatment was normal with no ulcer visualized. Conclusions: Early diagnosis and treatment of gastrointestinal (GI) mucormycosis infection is critical but can be challenging, especially in the setting of massive hematochezia. Therefore, clinical awareness for immunocompromised patients and prompt antifungal prophylaxis in cases with high suspicion of infection are essential.

Original languageEnglish
Article number272
JournalBMC Gastroenterology
Volume21
Issue number1
DOIs
Publication statusPublished - Dec 2021

Keywords

  • Case report
  • Diabetic ketoacidosis
  • Hematochezia
  • Mucormycosis
  • Opportunistic infection

ASJC Scopus subject areas

  • Gastroenterology

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