A Case of Gastric Mucormycosis, Vascular Invasive Type Associated with a Severe Malnutrition in a Non-diabetic Hemodialysis Patient / 대한신장학회잡지

ABSTRACT

Mucormycosis is an uncommon, frequently fatal, opportunistic fungal infection which usually develops in immunosuppressant patients, especially in patients with AIDS, organ transplantation, diabetic mellitus, administration of steroid, chronic illness, severe malnutrition. It is classified into four groups as clinical forms and one of its, gastrointestinal type is an unusual form, believed that infection of the gastrointestinal tract is acquired through ingestion of the ubiquitous fungal spores, the stomach being the most frequently involved site. Especially, gastric mucormycosis, vascular invasive type is frequently fatal. Recently we experienced a case of gastric mucormycosis, vascular invasive type found in a 74-year old male undergoing hemodialysis for chronic renal failure and he was in severe malnutrition. In the course of the admission, unexpectedly, hematemesis was developed. Upper gastrointestinal fiberoscopy was done and we found a ulcerative lesion, geographic in body of stomach and on histologic examination, characteristic findings of nonseptate hyphae with right angle branchings was observed in the ulcer debris with vessel invasion. The patient was treated with systemic antifungal agent, amphotericin B but expired due to massive hematemesis.