A case of subacute bowel obstruction revealing slowly-evolutive gastro-intestinal mucormycosis following allogeneic hematopoietic cell transplantation

J Mycol Med. 2022 Nov;32(4):101312. doi: 10.1016/j.mycmed.2022.101312. Epub 2022 Jul 25.

Abstract

Gastro-intestinal mucormycosis (GIMM) is a highly lethal invasive fungal disease partly because of a challenging diagnosis. An allogeneic hematopoietic cell transplant recipient experienced bowel obstruction caused by slowly-evolutive gastro-intestinal mucormycosis and was successfully treated with surgery and antifungal therapy. Pathological findings revealed a granuloma without angio-invasion, which is unusual in this fungal disease and has incomplete similarities with an immune reconstitution inflammatory syndrome. Mucorales-specific PCR in both serum and resected tissue was positive and helped assessing the diagnosis. GIMM should be considered in front of unexplained granulomatosis or bowel obstruction in immunocompromised patients.

Keywords: Allogeneic hematopoietic cell transplantation; Bowel obstruction; Granuloma; Isavuconazole; Mucormycosis.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Immunocompromised Host
  • Invasive Fungal Infections* / drug therapy
  • Mucorales*
  • Mucormycosis* / diagnosis
  • Mucormycosis* / drug therapy

Substances

  • Antifungal Agents