Rare and Fatal Gastrointestinal Mucormycosis (Zygomycosis) in a COVID-19 Patient: A Case Report
Clinical Endoscopy 2020³â 53±Ç 6È£ p.746 ~ p.749
(do Monte Epifanio Silvino Junior) - Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Gastrointestinal Endoscopy Unit
(dos Santos Marcos Eduardo Lera) - Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Gastrointestinal Endoscopy Unit
(Ribeiro Igor Braga) - Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Gastrointestinal Endoscopy Unit
(de Oliveira Luz Gustavo) - Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Gastrointestinal Endoscopy Unit
(Baba Elisa Ryoka) - Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Gastrointestinal Endoscopy Unit
(Hirsch Bruno Salomao) - Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Gastrointestinal Endoscopy Unit
(Funari Mateus Pereira) - Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Gastrointestinal Endoscopy Unit
(De Moura Eduardo Guimaraes Hourneaux) - Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas Gastrointestinal Endoscopy Unit
Abstract
The novel coronavirus disease (COVID-19) quickly spread to all continents. However, data regarding all the signs and symptoms of COVID-19 are insufficient. Patients with COVID-19 might present higher susceptibility to fungal coinfections. Mucormycosis is a rare and often life-threatening fungal disease characterized by vascular invasion by hyphae, resulting in thrombosis and necrosis. This is the first case report of mucormycosis in a COVID-19 patient. An 86-year-old male patient was admitted to the emergency room with acute diarrhea, cough, dyspnea, and fever from 5 days prior. Blood tests revealed a hemoglobin level of 14.3 mg/dL. Five days following the admission, the patient presented with melena and a hemoglobin level of 5.6 mg/dL. A transfusion of three units of red blood cells was required. Esophagogastroduodenoscopy (EGD) revealed two giant gastric ulcers with necrotic debris and a deep hemorrhagic base without active bleeding. Furthermore, biopsies confirmed mucormycosis. Despite intensive care, the patient died 36 hours after the EGD.
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Coronavirus infections, Gastroenteritis, Gastrointestinal hemorrhage, Mucormycosis, Zygomycosis
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GI mucormycosis is a rare disease, and it should be considered if an atypical gastric ulcer is identified in a COVID-19 patient.