Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Korean J Gastroenterol. 2023 May 25;81(5):221-225. doi: 10.4166/kjg.2023.015.
Gastrointestinal mucormycosis is a rare disease with a significant mortality rate, even when promptly diagnosed and treated. An unusual complication was observed in India during the second wave of coronavirus disease 2019 (COVID-19). Two incidences of gastric mucormycosis were found. A 53-year-old male patient with a history of COVID-19 one month earlier came into the intensive care unit. After admission, the patient developed hematemesis, which was initially treated with blood transfusions and digital subtraction angiography embolization. Esophagogastroduodenoscopy (EGD) revealed a large ulcer with a clot in the stomach. During an exploratory laparotomy, the proximal stomach was necrotic. Histopathological examination confirmed mucormycosis. The patient was started on antifungals, but despite rigorous therapy, the patient died on the tenth postoperative day. Another patient, an 82-year-old male with a history of COVID-19, arrived with hematemesis two weeks earlier and was treated conservatively. EGD revealed a large white-based ulcer with abundant slough along the larger curvature of the body. Mucormycosis was verified by biopsy. He was treated with amphotericin B and isavuconazole. He was discharged after two weeks in a stable condition. Despite quick detection and aggressive treatment, the prognosis is poor. In the second case, prompt diagnosis and treatment saved the patient's life.
胃肠道毛霉菌病是一种罕见疾病，死亡率很高，即使及时诊断和治疗也是如此。在 2019 年冠状病毒病（COVID-19）第二波期间，印度观察到一种不常见的并发症。发现了两例胃毛霉菌病。一名 53 岁的男性患者，一个月前有 COVID-19 病史，住进了重症监护病房。入院后，患者出现呕血，最初采用输血和数字减影血管造影栓塞治疗。食管胃十二指肠镜（EGD）显示胃中有一个大溃疡，伴有血块。在剖腹探查术中，近端胃坏死。组织病理学检查证实为毛霉菌病。患者开始使用抗真菌药物，但尽管进行了严格的治疗，患者还是在术后第十天死亡。另一名患者是一名 82 岁的男性，有 COVID-19 病史，两周前出现呕血，并接受了保守治疗。EGD 显示胃体大弯侧有一个白色基底的大溃疡，有大量腐肉。活检证实为毛霉菌病。他接受了两性霉素 B 和伊曲康唑治疗。两周后，患者病情稳定出院。尽管快速检测和积极治疗，预后仍不佳。在第二例中，及时诊断和治疗挽救了患者的生命。
