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Cirujano general

versão impressa ISSN 1405-0099

Resumo

ISLAS TORRES, Martín et al. Emphysematous gastritis secondary to gastric mucormycosis in a patient with COVID-19. Case report. Cir. gen [online]. 2022, vol.44, n.2, pp.87-92.  Epub 13-Out-2023. ISSN 1405-0099.  https://doi.org/10.35366/109718.

Introduction:

mucormycosis is an invasive fungal infection with high mortality, which occurs mostly in immunocompromised patients. This disease is characterized by necrotizing vasculitis and the presence of aseptate hyphae with wide-angle branching. Gastrointestinal mucormycosis is one of the rarest, symptoms are nonspecific and only 25% of cases are diagnosed premortem. The treatment is based on antifungals and urgent surgical debridement.

Clinical case:

a 69 year-old male with history of type 2 diabetes presents with dyspnea, SARS-CoV-2 rapid antigen test turned out positive. During hospital stay the patient presents sepsis, gastrointestinal bleeding, and pneumoperitoneum on abdominal computed axial tomography (CT). Laparotomy is performed, in which necrosis along the greater curvature of the stomach is found, therefore a vertical gastrectomy is carried out. Histopathology report reveals panmural necrosis associated with arterial thrombosis secondary to Mucor sp., parenteral liposomal amphotericin B is initiated, however, the patient develops health-care associated pulmonary and urinary infections, decease is documented 29 days after admission.

Conclusion:

mucormycosis is a fungal emerging infection, which requires a high suspicion for diagnosis. Antifungal and surgical debridement by a general surgeon represents an essential measure in the treatment of this entity.

Palavras-chave : gastrointestinal mucormycosis; emphysematous gastritis; vertical gastrectomy; COVID; case report.

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