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Successful Treatment of Invasive Gastric Mucormycosis in a Kidney Transplant Recipient
J Korean Soc Transplant 2018;32:104-107
Published online December 31, 2018
© 2018 The Korean Society for Transplantation.

Hyung Nam Kim, M.D.1, Sun Ae Han, M.D.1, Ha Yeol Park, M.D.1, Hyun Woo Kim, M.D.1
Ran Hong, M.D.2, Nam Gyu Choi, M.D.3, Min Ho Shin, M.D.3, Na Ra Yoon, M.D.1
Hyun Lee Kim, M.D.1, Jong Hoon Chung, M.D.1, and Byung Chul Shin, M.D.1

Departments of Internal Medicine1, Pathology2, and Surgery3, Chosun University College of Medicine, Gwangju, Korea
Correspondence to: Byung Chul Shin
Department of Internal Medicine, Chosun University Hospital, Chosun University College of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea
Tel: 82-62-220-3967, Fax: 82-62-234-9653
E-mail: bcshin@chosun.ac.kr
Received May 17, 2018; Revised October 1, 2018; Accepted October 16, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Gastrointestinal (GI) mucormycosis is very rare and occurs primarily in highly malnourished patients, especially in infants and children. A 55-year-old man with end-stage renal disease due to diabetic nephropathy, who had undergone deceased donor kidney transplantation 2 years prior, complained of abdominal pain and distension with a 3-day duration. Computed tomography revealed diffuse gastric wall thickening, and a huge amount of grey colored necrotic debris surrounded by erythematous erosive mucosa was observed at the antrum to upper body by GI endoscopy. The microscopic examination obtained from a GI endoscopic specimen demonstrated peptic detritus with numerous non-septate mucor hyphae in the mucosa and submucosa. Mucormycosis was diagnosed based on the clinical findings and morphological features. A total gastrectomy was performed and an antifungal agent was administered. A microscopic examination of the surgical specimen demonstrated invasive mucormycosis with numerous fungal hyphae with invasion into the mucosa to subserosa. The patient and graft were treated successfully by total gastrectomy and antifungal therapy.
Keywords : Mucormycosis, Kidney transplantation, Stomach


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