Gastrointestinal mucormycosis: A periodic systematic review of case reports from 2015 to 2021

• Published in: Microbial pathogenesis 2022-02, Vol.163, p.105388-105388, Article 105388
• Main Authors: Didehdar, Mojtaba, chegini, Zahra, Moradabadi, Alireza, Anoushirvani, Ali Arash, Tabaeian, Seidamir Pasha, Yousefimashouf, Milad, Shariati, Aref
• Format: Article
• Language: English
• Subjects: Adult; Antifungal Agents - therapeutic use; Corticosteroid therapy; COVID-19; Diabetes Mellitus; Gastrointestinal; Humans; Infant; Infant, Newborn; Intestines; Mucormycosis; Mucormycosis - diagnosis; Mucormycosis - drug therapy; Mucormycosis - epidemiology; SARS-CoV-2; Stomach
• ISSN: 0882-4010; 1096-1208
• DOI: 10.1016/j.micpath.2022.105388

GI mucormycosis (GI) is a rare but highly lethal infection in patients. There is no single comprehensive review of the literature that demonstrates the various clinical aspects of this infection. A structured search of PubMed/Medline was used to collect case reports of GI mucormycosis in patients of all ages published between 2015 and November 2021. Eighty-seven cases were identified through PubMed bibliographic database searches, and final analyses were conducted on 70 adults and ten neonatal patients with GI mucormycosis. Asia had the highest number of reported cases, with 46 (57.5%). Neonatal cases had a mortality rate of 70%, while other cases had a mortality rate of 44%. Corticosteroid therapy and diabetes were the most significant risk factors in patients, while 11% were immunocompetent with no apparent underlying condition. COVID-19 positivity was detected in four adult patients. Moreover, neonatal cases included premature and low-weight infants, metabolic acidosis, and malnutrition. Abdominal pain, fever, and GI perforation were the most common signs of infection, while vomiting occurred in 40% of neonatal cases. In 97% of patients, a histopathologic examination was used to detect infection, whereas culture and molecular methods were used in only 28% and 17% of patients, respectively. Surgery plus anti-infection therapy, anti-infection therapy alone, and surgery alone were used in 61%, 28%, and 11% of patients, respectively. Nonetheless, all neonatal patients underwent surgery. Although used in a small number of patients, posaconazole (30%) and isavuconazole (11%) demonstrated high efficacy in treating patients. GI mucormycosis is a rare but highly lethal disease. Treatment of underlying conditions, the use of multiple diagnostic techniques, and appropriate antifungals in conjunction with surgery can all contribute to infection control. •Neonatal cases had a mortality rate of 70%, while other cases had a mortality rate of 44%.•Corticosteroid therapy, diabetes and blood malignancies were the most underlying disorders in the patients with GI mucormycosis.•COVID-19 positivity was detected in four (6%) adult patients•Abdominal pain (50%), fever (37%), and GI perforation (27%) were the most frequently reported GI mucormycosis manifestations in patients.•Rhizopus spp. being the most frequently isolated pathogen from patients with GI mucormycosis.•Posaconazole and isavuconazole demonstrated high efficacy in treating patients.