Hamamah Sevag, Savalia Nupur, Hai Faizi
Internal Medicine, Scripps Mercy Hospital, San Diego, USA.
Gastroenterology, Scripps Mercy Hospital, San Diego, USA.
Cureus. 2025 Mar 17;17(3):e80730. doi: 10.7759/cureus.80730. eCollection 2025 Mar.
Mucormycosis is a severe, opportunistic infection caused by a taxonomical group of thermotolerant fungi primarily affecting the immunocompromised. Intra-abdominal involvement in mucormycosis is a rare entity, particularly in immunocompetent individuals. We present a fatal case of gallbladder and renal mucormycosis in an immunocompetent female, leading to septic shock and death. The diagnosis was confirmed via histopathology following cholecystectomy for suspected gangrenous cholecystitis and open right nephrectomy due to kidney infarction. Quantitative polymerase chain reaction of the tissue identified the presence of The clinical picture was confounded by ongoing sepsis due to a -infected retroperitoneal hematoma non-specific imaging findings, and the absence of traditional risk factors for mucormycosis, leading to a delayed diagnosis. Despite surgical debridement, initiation of liposomal amphotericin B with posaconazole, and aggressive treatment in the intensive care unit, the patient succumbed to complications of mucormycosis. Despite adequate antibiotic coverage, this case underscores the importance of considering Mucorales infection in otherwise immunocompetent patients with a deteriorating clinical condition. Early diagnosis and appropriate intervention are essential in enhancing mucormycosis survivability, though mortality rates remain high in severe cases.
毛霉病是一种由一组耐热真菌引起的严重机会性感染,主要影响免疫功能低下者。毛霉病累及腹腔是一种罕见情况,在免疫功能正常个体中尤为罕见。我们报告一例免疫功能正常女性发生胆囊和肾脏毛霉病的致死病例,最终导致感染性休克和死亡。在因疑似坏疽性胆囊炎行胆囊切除术以及因肾梗死行右侧开放性肾切除术后,通过组织病理学确诊了该病例。组织的定量聚合酶链反应确定存在 临床情况因感染性腹膜后血肿导致的持续脓毒症、非特异性影像学表现以及缺乏毛霉病的传统危险因素而变得复杂,导致诊断延迟。尽管进行了手术清创、启动了脂质体两性霉素B联合泊沙康唑治疗以及在重症监护病房进行了积极治疗,但患者仍死于毛霉病并发症。尽管给予了充分的抗生素覆盖,但该病例强调了在临床状况恶化的免疫功能正常患者中考虑毛霉目感染的重要性。早期诊断和适当干预对于提高毛霉病的生存率至关重要,尽管严重病例的死亡率仍然很高。