Gastric Black Fungus: A Rare Case Report

Abstract

Mucormycosis is an opportunistic fungal infection that typically affects patients with diabetes mellitus or immunosuppression. The fungus invades nearby blood vessels, leading to thrombosis and organ necrosis. While Mucorales can infiltrate any organ in the body, the gastrointestinal system is an uncommon site for infection. Gastric mucormycosis is a rare but potentially lethal fungal infection resulting from the invasion of Mucorales into the gastric mucosa, exhibiting angioinvasive characteristics. It can lead to high mortality rates due to the increased risk of complications in immunocompromised patients. Common predisposing factors include diabetes mellitus, neutropenia, iron overload states, malnourishment, and other immunocompromised conditions. Mucormycosis is a fatal infection, necessitating prompt intervention to ensure survival. In this case report, authors present a 42-year-old man with a history of chronic alcoholism and chronic kidney disease who presented with complaints of abdominal pain and vomiting for six months, significant weight loss, and loss of appetite for one month. Initially suspected clinically and radiologically as a malignant gastric ulcer, an endoscopy was performed, and a gastric biopsy was sent for Histopathological Examination (HPE). Histological analysis of the gastric biopsy revealed multiple fragments of gastric mucosa with areas of ulceration, neutrophilic abscess, and numerous broad aseptate obtuse-angle fungal hyphae resembling Mucorales. The presence of the organisms was confirmed through special stains for fungus. Very few cases of invasive gastric mucormycosis associated with uncontrolled diabetes, alcoholism, and chronic kidney disease have been reported in the literature.