Published online Feb 25, 2018. doi: 10.5495/wjcid.v8.i1.1
Peer-review started: September 16, 2017
First decision: October 23, 2017
Revised: November 9, 2017
Accepted: November 27, 2017
Article in press: November 27, 2017
Published online: February 25, 2018
We present a 38 years old female seen in our hospital with a 2 wk history of productive cough dyspnoea and lethargy.
On clinical examination she had oral thrush, more than 1 cm cervical and axillary lymphadenopathy, pallor with an ejection systolic murmur, hypotension, tachycardia and respiratory failure.
Differential diagnosis of human immunodeficiency virus infection with candidiasis, TB pneumonia and gastrointestinal bleed was made.
She was found to have severe anemia, acquired immune deficiency syndrome with pneumonia, esophageal candidiasis and gastric mucormycosis and gastric bleed.
CXR showed multi-lobar pneumonia and gastroscopy showed gastric plaques as shown in Figure 1.
Gastric biopsy showed fungal hyphae consistent with mucormycosis as shown in Figure 2.
She was started on anti-tuberculosis treatment, fluconazole broad spectrum antibiotics followed a few days later by amphotericin B.
She failed to respond to fluconazole and only responded to amphotericin B.
Mucormycosis is an invasive fungal infection seen only in patients with reduced immune system.
Mucormycosis infect the stomach and can co-exist with candida.