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Ileocolonic mucormycosis in adult immunocompromised patients: a surgeon's perspective

Oswens Siu-Hung Lo1, Wai-Lun Law

  • 1Division of Colorectal Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam Road, Hong Kong, China.

World Journal of Gastroenterology
|March 6, 2010
PubMed

Insights

Ileocolic mucormycosis, a rare fungal infection, presents as acute abdomen in immunocompromised patients. Early diagnosis and surgical intervention are critical but challenging, often leading to poor outcomes in neutropenic individuals.

Area of Science:

  • Mycology
  • Gastroenterology
  • Surgical Oncology

Background:

  • Mucormycosis is a life-threatening fungal infection, particularly in immunocompromised individuals.
  • Gastrointestinal mucormycosis is uncommon and difficult to diagnose antemortem.
  • Ileocolic involvement presents as an acute abdominal emergency.

Observation:

  • Three adult immunocompromised patients with hematological malignancy presented with acute abdomen due to ileocolic mucormycosis.
  • All patients underwent emergency laparotomy.
  • Two patients died from multiorgan failure before diagnosis confirmation.

Findings:

  • Antemortem diagnosis of gastrointestinal mucormycosis is challenging, with a reported success rate of only 25%-50%.
  • Surgical management of acute abdomen in neutropenic patients with hematological malignancy poses significant difficulties.
  • Ileocolic mucormycosis has a high mortality rate if not diagnosed and treated promptly.

Implications:

  • Highlights the critical need for increased clinical suspicion of mucormycosis in immunocompromised patients with acute abdomen.
  • Emphasizes the diagnostic challenges and poor prognosis associated with gastrointestinal mucormycosis.
  • Underscores the importance of timely diagnosis and multidisciplinary management for improving patient outcomes.

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