Invasive Gastrointestinal Mucormycosis Presenting as Neutropenic Enterocolitis: A Case Report Article Swipe

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Hamad J. AlBassam , Wael A. Alanazi , Farzana Rashid , Zainab I. Alruwaii , Zainab AlMusa ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.12659/ajcr.948878

BACKGROUND Gastrointestinal mucormycosis is an underrecognized and underreported fungal infection with a high mortality rate. Diagnosis is often confounded by a non-specific constellation of signs and symptoms. We present a case of neutropenic colitis and ileocecal perforation secondary to gastrointestinal mucormycosis. CASE REPORT The patient was a 19-year-old man recently diagnosed with B-cell acute lymphoblastic leukemia, on active chemotherapy. He presented with abdominal pain and tenderness, and a contrast-enhanced CT revealed neutropenic colitis. Despite broad-spectrum antibiotics, his condition worsened, prompting reassessment. Follow-up CT showed bowel ischemia and a pelvic collection. He underwent an emergency laparotomy, which revealed destruction of the anterior cecal wall and detachment from the terminal ileum and ascending colon. Ileocecal resection was performed and histopathologic examination demonstrated angioinvasive fungal elements consistent with Mucor spp. He was diagnosed with gastrointestinal mucormycosis and promptly started on amphotericin intravenously. He improved over the next 2 weeks and was discharged with a plan to continue his 6-week course as an outpatient, followed by oral posaconazole maintenance therapy. Several weeks later, his infection relapsed secondary to non-compliance. He underwent repeat surgical debridement and antimicrobial therapy was restarted with intravenous amphotericin and Isavuconazole. He successfully completed 6 weeks of treatment and was transitioned to oral Isavuconazole prophylaxis. He remained stable and relapse-free at 6 months following his second procedure. CONCLUSIONS The case highlights the importance of early recognition of patients at risk for this infection, maintaining a high index of suspicion, and employing aggressive medical and surgical management strategies to avoid mortality.

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Medicine Mucormycosis Enterocolitis Intensive care medicine Neutropenia Internal medicine Surgery Chemotherapy

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Type: article
Language: en
Landing Page: https://doi.org/10.12659/ajcr.948878
PDF: https://amjcaserep.com/download/inPress/idArt/948878
OA Status: hybrid
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OpenAlex ID: https://openalex.org/W4413042069

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DOI: https://doi.org/10.12659/ajcr.948878

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Title: Invasive Gastrointestinal Mucormycosis Presenting as Neutropenic Enterocolitis: A Case Report

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Type: article

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Language: en

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Publication year: 2025

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Publication date: 2025-08-07

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Authors: Hamad J. AlBassam, Wael A. Alanazi, Farzana Rashid, Zainab I. Alruwaii, Zainab AlMusa

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Landing page: https://doi.org/10.12659/ajcr.948878

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PDF URL: https://amjcaserep.com/download/inPress/idArt/948878

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OA status: hybrid

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Concepts: Medicine, Mucormycosis, Enterocolitis, Intensive care medicine, Neutropenia, Internal medicine, Surgery, Chemotherapy

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Cited by: 0

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Related works (count): 10

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abstract_inverted_index.on	56, 136
abstract_inverted_index.to	38, 152, 173, 200, 246
abstract_inverted_index.The	43, 217
abstract_inverted_index.and	6, 25, 34, 64, 66, 86, 103, 109, 116, 133, 146, 180, 188, 197, 207, 238, 242
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abstract_inverted_index.his	76, 154, 169, 213
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abstract_inverted_index.6-week	155
abstract_inverted_index.B-cell	52
abstract_inverted_index.REPORT	42
abstract_inverted_index.active	57
abstract_inverted_index.colon.	111
abstract_inverted_index.course	156
abstract_inverted_index.fungal	8, 121
abstract_inverted_index.later,	168
abstract_inverted_index.months	211
abstract_inverted_index.pelvic	88
abstract_inverted_index.repeat	177
abstract_inverted_index.second	214
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abstract_inverted_index.Several	166
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abstract_inverted_index.Ileocecal	112
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abstract_inverted_index.ascending	110
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abstract_inverted_index.employing	239
abstract_inverted_index.following	212
abstract_inverted_index.ileocecal	35
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abstract_inverted_index.suspicion,	237
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abstract_inverted_index.destruction	97
abstract_inverted_index.examination	118
abstract_inverted_index.intravenous	186
abstract_inverted_index.laparotomy,	94
abstract_inverted_index.maintaining	232
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abstract_inverted_index.recognition	224
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abstract_inverted_index.mucormycosis	2, 132
abstract_inverted_index.non-specific	21
abstract_inverted_index.posaconazole	163
abstract_inverted_index.prophylaxis.	203
abstract_inverted_index.relapse-free	208
abstract_inverted_index.successfully	191
abstract_inverted_index.transitioned	199
abstract_inverted_index.Isavuconazole	202
abstract_inverted_index.angioinvasive	120
abstract_inverted_index.antimicrobial	181
abstract_inverted_index.chemotherapy.	58
abstract_inverted_index.constellation	22
abstract_inverted_index.lymphoblastic	54
abstract_inverted_index.mucormycosis.	40
abstract_inverted_index.reassessment.	80
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abstract_inverted_index.broad-spectrum	74
abstract_inverted_index.intravenously.	138
abstract_inverted_index.histopathologic	117
abstract_inverted_index.non-compliance.	174
abstract_inverted_index.underrecognized	5
abstract_inverted_index.Gastrointestinal	1
abstract_inverted_index.gastrointestinal	39, 131
abstract_inverted_index.contrast-enhanced	68
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