Invasive mucormycosis in benign gastric ulcer.
Fungal elements are frequently noted overlying the base of chronic peptic ulcers of the stomach and it has been suggested that the fungi enhance the degree of necrosis and that these cases have protracted disease and deeper ulcers with more perforations. It has also been postulated that the number of fungal elements might be increased in the stomach of patients who are receiving potent medications such as H2-receptor antagonists to reduce gastric acidity, but there have not been adequate control studies, and the deleterious effects from the presence of the fungi in these cases have not been substantiated. We present a very rare case of invasive mucormycosis (phycomycosis) occurring in the base of a chronic gastric ulcer in a 55 years old diabetic male. This case was clinically and radiologically been mistaken for a gastric carcinoma. In addition, the ulcer was complicated by perforation and fungal septicemia with subsequent fatal outcome. The clinical, radiological and histopathological features are described together with a literature review of other reported fungal gastric ulcers.
Al-Rikabi
A C
AC
Department of Histopathology, King Khalid University Hospital, PO Box 186, Riyadh 11323, Kingdom of Saudi Arabia.
Al-Dohayan
A D
AD
Al-Boukai
A A
AA
D015746:Abdominal Pain / Q000382:microbiology; D000855:Anorexia / Q000382:microbiology; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001466:Barium Sulfate; D001706:Biopsy; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003287:Contrast Media; D048909:Diabetes Complications; D017809:Fatal Outcome; D005743:Gastrectomy; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000150:complications* / Q000175:diagnosis*; D010439:Peptic Ulcer Perforation / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013276:Stomach Ulcer / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D015431:Weight Loss
D000897:Anti-Ulcer Agents; D003287:Contrast Media; D001466:Barium Sulfate