title: Gastrointestinal mucormycosis in immunocompromised hosts.
abstract: Invasive mucormycosis is a rare fungal infection in immunocompromised hosts, but it carries a high mortality rate. Primary gastrointestinal disease is the least frequent form of presentation. Early diagnosis and treatment are critical in the management; however, symptoms are typically non-specific in gastrointestinal disease, leading to delayed therapy. To describe the clinical presentation, diagnosis, treatment and outcomes of gastrointestinal mucormycosis in immunocompromised hosts, we reviewed all cases of primary gastrointestinal mucormycosis in immunocompromised hosts reported in English literature as well as in our Institution from January 1st 1991 to December 31st 2013 for a total of 31 patients. About 52% of patients underwent solid organ transplant (SOT), while the rest had an underlying haematologic malignancy. Abdominal pain was the most common presenting symptom, followed by gastrointestinal bleeding and fever. Gastric disease was more common in SOT, whereas those with haematologic malignancy presented with intestinal disease (P = 0.002). Although gastrointestinal mucormycosis remains an uncommon condition in immunocompromised hosts, it carries significant morbidity and mortality, particularly in cases with intestinal involvement. A high index of suspicion is of utmost importance to institute early and appropriate therapy and improve outcomes.
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: M Veronica
authors.initials: MV
authors.lastname: Dioverti
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Cawcutt
authors.affiliation: Division of Infectious Diseases, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Maheen
authors.initials: M
authors.lastname: Abidi
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: M Rizwan
authors.initials: MR
authors.lastname: Sohail
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Randall C
authors.initials: RC
authors.lastname: Walker
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Osmon
mesh_terms: D015746:Abdominal Pain; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D019337:Hematologic Neoplasms / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D016377:Organ Transplantation / Q000009:adverse effects; D035583:Rare Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D055815:Young Adult
keywords: Mucormycosis; fungal infections; immunocompromised