Gastrointestinal Zygomycosis Masquerading as Acute Appendicitis

Area of Science:

• Mycology
• Infectious Diseases
• Oncology

Background:

• Zygomycosis is a rare, invasive opportunistic fungal infection.
• It commonly affects immunocompromised individuals, particularly those with hematologic malignancies, neutropenia, or on immunosuppressive therapy.

Observation:

• This report details the first case of disseminated appendiceal zygomycosis caused by Absidia spp.
• The patient, a 63-year-old woman with acute myeloid leukemia, presented with symptoms mimicking acute appendicitis during chemotherapy.
• Initial symptoms included abdominal pain and diarrhea, unresponsive to antibiotics, leading to a clinical suspicion of appendicitis.

Findings:

• Histological examination of the ileocecectomy specimen revealed angioinvasive fungal organisms consistent with zygomycetes in the necrotic appendiceal wall.
• Fungal cultures confirmed the presence of Absidia spp.
• Despite treatment with amphotericin B, the patient succumbed to disseminated fungal sepsis.

Implications:

• Zygomycosis should be considered in neutropenic patients presenting with acute appendicitis symptoms.
• Prompt diagnosis via histology and fungal cultures is vital for improving outcomes.
• High clinical suspicion can reduce the significant morbidity and mortality associated with gastrointestinal zygomycosis.