Gastrointestinal mucormycosis in immunocompromised hosts

Area of Science:

• Mycology
• Infectious Diseases
• Gastroenterology

Background:

• Invasive mucormycosis is a life-threatening fungal infection predominantly affecting immunocompromised individuals.
• Primary gastrointestinal mucormycosis is an uncommon but severe manifestation with high mortality.
• Non-specific symptoms often lead to delayed diagnosis and treatment of gastrointestinal mucormycosis.

Purpose of the Study:

• To elucidate the clinical presentation, diagnostic approaches, treatment strategies, and outcomes of gastrointestinal mucormycosis.
• To analyze cases of primary gastrointestinal mucormycosis in immunocompromised hosts from literature and institutional data.
• To highlight the importance of early detection and intervention for this rare condition.

Main Methods:

• Systematic review of English literature and institutional records of primary gastrointestinal mucormycosis cases.
• Inclusion criteria: immunocompromised hosts, primary gastrointestinal involvement, reported between January 1, 1991, and December 31, 2013.
• Data analysis focused on clinical presentation, underlying conditions, disease site, and patient outcomes.

Main Results:

• A total of 31 patients were analyzed, with 52% having undergone solid organ transplantation (SOT) and the remainder having hematologic malignancies.
• Abdominal pain, gastrointestinal bleeding, and fever were the most frequent presenting symptoms.
• Gastric mucormycosis was more prevalent in SOT recipients, while intestinal disease predominated in those with hematologic malignancies (P = 0.002).

Conclusions:

• Gastrointestinal mucormycosis, though rare, is associated with significant morbidity and mortality in immunocompromised patients.
• Intestinal involvement confers a particularly poor prognosis.
• A high index of suspicion is essential for timely diagnosis and effective management to improve patient outcomes.