Ahmad Zubair, Arshad Sidra, Idrees Romana, Abdul-Ghafar Jamshid, Din Nasir Ud
Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
Department of Pathology and Laboratory Medicine, French Medical Institute for Mothers Children (FMIC), Kabul, Afghanistan.
J Coll Physicians Surg Pak. 2019 Feb;29(2):181-184. doi: 10.29271/jcpsp.2019.02.181.
The importance and frequency of invasive fungal infections in different organs, including the gastrointestinal tract, has increased due to excessive use of aggressive immunosuppressive and immunomodulatory drugs in malignant diseases and organ transplantations as well as increased infections with the human immunodeficiency virus (HIV). Fungal infections in the small intestine or colon are usually part of a disseminated disease process and reach these organs through the bloodstream. Two of the patients were infants 10 and 15 days of age, while one was 23 years old. Patients presented with abdominal pain, intestinal obstruction, and rectal bleeding. Hirchsprung disease was suspected in the two infants. In the adult patient, the diagnosis was unclear. Mucormycosis was diagnosed in two out of three cases. It is imperative for clinicians to consider invasive mycosis in the differential diagnosis in patients of all ages with treatment-resistant severe abdominal pain, diarrhea and fever.
由于在恶性疾病和器官移植中过度使用强效免疫抑制和免疫调节药物以及人类免疫缺陷病毒(HIV)感染增加,包括胃肠道在内的不同器官侵袭性真菌感染的重要性和发生率有所上升。小肠或结肠的真菌感染通常是播散性疾病过程的一部分,并通过血流到达这些器官。其中两名患者是10天和15天大的婴儿,另一名患者为23岁。患者表现为腹痛、肠梗阻和直肠出血。两名婴儿疑似患有先天性巨结肠。成年患者的诊断尚不明确。三例中有两例诊断为毛霉病。临床医生必须在对所有年龄患有难治性严重腹痛、腹泻和发热的患者进行鉴别诊断时考虑侵袭性真菌病。