Fatal peritonitis caused by Rhizopus microsporus

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Hervé Hyvernat1, Brigitte Dunais, Fanny Burel-Vandenbos

  • 1Medical Intensive Care Unit, Archet 1 Hospital, Nice, France. hyvernat.h@chu-nice.fr

Medical Mycology
|May 15, 2010
PubMed

Insights

A rare fungal infection caused by Rhizopus microsporus led to fatal recurrent peritonitis in a Crohn's disease patient. This case highlights the critical need for prompt diagnosis of invasive fungal infections in immunocompromised individuals.

Area of Science:

  • Gastroenterology
  • Mycology
  • Infectious Diseases

Background:

  • Crohn's disease (a chronic inflammatory bowel condition) can predispose patients to serious infections.
  • Peritonitis, inflammation of the abdominal lining, is a severe complication often requiring surgical intervention.

Observation:

  • A 52-year-old woman with Crohn's disease presented with peritonitis secondary to intestinal perforation.
  • Initial treatment with voriconazole was followed by recurrent peritonitis, necrosis, and perforation of the left colon, leading to patient demise.

Findings:

  • Microscopic examination of peritoneal fluid revealed broad, irregular hyphae.
  • Culture of peritoneal fluid and colon tissue successfully identified Rhizopus microsporus, a rare cause of invasive fungal infection.
  • Fungal identification was confirmed via characteristic morphology and rDNA ITS sequencing.

Implications:

  • This case underscores the potential for Rhizopus microsporus to cause life-threatening invasive infections, particularly in immunocompromised patients.
  • Early and accurate diagnosis of fungal peritonitis is crucial for effective management and improved patient outcomes.
  • Further research into the management of invasive fungal infections in inflammatory bowel disease patients is warranted.

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