Invasive gastrointestinal zygomycosis in a liver transplant recipient: case report.
BACKGROUND
Gastric zygomycosis is a rare but potentially lethal complication in transplant patients. Forty-two cases of gastric mucormycosis have been described in the literature, with a mortality of 98%.


METHODS
We report of a case of gastric mucormycosis in a 45-year-old male undergoing liver transplantation for alcohol-induced cirrhosis. The diagnosis was made 20 days after transplantation in a biopsy of a bleeding gastric ulcer identified during a reoperation for a common bile duct stricture.


RESULTS
After the surgical procedure and therapy with amphotericin B, the patient made a good recovery and is alive and well 2 years after transplantation.


CONCLUSIONS
Gastric mucormycosis should be suspected in those patients in whom gastrointestinal symptoms such a pain or bleeding are present. Because the diagnosis is dependent on histology, the importance of biopsy cannot be underestimated. Once diagnosed, a successful outcome depends on effective treatment with amphotericin.
Vera
Alonso
A
Liver & Hepatobiliary Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, England, B15 2TH.
Hubscher
Stefan G
SG
McMaster
Paul
P
Buckels
John A C
JA
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology*; D012086:Reoperation; D013276:Stomach Ulcer / Q000382:microbiology / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome; D020096:Zygomycosis / Q000175:diagnosis* / Q000188:drug therapy
D000935:Antifungal Agents; D000666:Amphotericin B