A fatal case of gastric mucormycosis and diabetic ketoacidosis.
OBJECTIVE
To describe a case of gastric mucormycosis in conjunction with severe bleeding in a young woman, which occurred after an episode of ketoacidosis and had a fatal outcome.


METHODS
We present a case report, including detailed clinical and pathologic findings in a woman with gastric mucormycosis associated with severe bleeding.


RESULTS
A 17-year-old woman sought medical assistance for diabetic ketoacidosis and severe epigastric pain. Chest radiography showed normal findings, and blood and urine cultures were negative for bacterial growth. Endoscopy disclosed an extensive ulcerated lesion involving the greater curvature and posterior wall of the stomach. Biopsy specimens demonstrated the presence of invasive mucormycosis. Treatment with amphotericin B was initiated, but severe persistent gastrointestinal bleeding resulted in the patient's demise.


CONCLUSIONS
In conjunction with diabetic ketoacidosis, severe infection by Mucor has been reported mainly in the rhino-orbital area. Although uncommon, the gastrointestinal tract can also be involved. In the case described, severe hemorrhage ensued and caused the patient's death.
Paulo De Oliveira
José Egídio
JE
Department of Internal Medicine, Medical School, and Diabetes and Nutrition Division of Hospital Universitario Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brazil.
Milech
Adolpho
A
D015746:Abdominal Pain; D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000150:complications*; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006801:Humans; D009091:Mucormycosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013272:Stomach Diseases / Q000382:microbiology*
D000935:Antifungal Agents; D000666:Amphotericin B