Unusual presentation of mucormycosis

• Main Authors: Sanjiv Saxena, Sonia Sharma, Ravi Bansal, S B Kulkarni
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Indian Journal of Transplantation
• Subjects: Gastric mucormycosis; Kidney transplant and fungal infection; Mucormycosis and immunosuppression
• Online Access: http://www.ijtonline.in/article.asp?issn=2212-0017;year=2016;volume=10;issue=2;spage=52;epage=54;aulast=Saxena;type=0

Early post-kidney transplant period is at high risk of acquiring fungal infections due to maximum immunosuppression. We are reporting case of a 39-year-old male who did well for 16 years after renal transplantation, and then had gastric mucormycosis mimicking acute pancreatitis while on low dose maintenance immunosuppression. At admission, his clinical and laboratory parameters were suggestive of the acute pancreatitis but further worsening needed invasive investigations. Endoscopy was done and histopathology of large irregular gastric ulcer with yellow base and raised margin and tissue staining confirmed the fungus. Subsequent treatment with combined fungal therapy of amphotericin and posaconazole did not save our patient. The case highlights that mucor can present late when on low dose immunosuppression and can mimic acute pancreatitis.