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首页> 外文期刊>American Journal of Case Reports >A Cecal Mucormycosis Mass Mimicking Colon Cancer in a Patient with Renal Transplant: A Case Report and Literature Review
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A Cecal Mucormycosis Mass Mimicking Colon Cancer in a Patient with Renal Transplant: A Case Report and Literature Review

机译：患有肾移植患者的脑膜炎癌症质量模仿结肠癌：案例报告和文献综述

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Patient: Male, 64-year-old Final Diagnosis: Cecal mucormycosis Symptoms: Abdominal pain ? diarhea ? nausea ? vomiting Medication: — Clinical Procedure: Ileostomy placement ? right hemicolectomy Specialty: Surgery Objective: Unusual clinical course Background: Mucormycosis is a rare, invasive, and opportunistic fungal infection that occurs in the setting of neutropenia, immune deficiency, solid-organ transplant, and iron overload. The gastrointestinal system is a rare site of mucormycosis, and gastrointestinal mucormycosis is associated with high mortality and accounts for 4–7% of all cases. Case Report: We present the case of a 64-year-old hypertensive man with transfusion-dependent myelodysplastic syndrome who underwent renal transplant surgery 11 years ago. He also was taking maintenance Deferasirox for iron overload. He presented with a 2-day history of right lower-quadrant abdominal pain, nausea, vomiting, and non-bloody diarrhea. An abdominal examination revealed guarding and a 5×6 cm mass in the right iliac fossa. A CT scan of the abdomen showed signs of perforation of a cecal mass. As the patient was unstable, emergency right hemicolectomy and end ileostomy were performed. After the surgery, the patient was moved to the Intensive Care Unit (ICU) and a broad-spectrum antibiotic was administered. Histopathological examination results received on postoperative day 5 showed broad pauciseptate hyphae with substantial blood-vessel infiltration, suggestive of mucormycosis. Amphotericin B was started; however, on the same day, his condition deteriorated and he was moved back to the ICU. Despite maximum cardiorespiratory support, he had multiorgan failure and died. Conclusions: Gastrointestinal mucormycosis presentation is non-specific, the diagnosis is often made late or is missed, and mortality remains high. High clinical suspicion, early diagnosis, and combined antifungal and surgical treatment is the best way to reduce mortality and improve survival.
机译：患者：男，64岁的最终诊断：盲肠粘膜症症状：腹痛吗？腹泻？恶心 ？呕吐药物： - 临床手术：IleoStomy放置？右半聚切除术专业：手术目标：异常临床课程背景：粘液菌是一种罕见的，侵入性和机会性的真菌感染，在中性粒细胞减少，免疫缺陷，固体器官移植和铁过载的设置中发生。胃肠系统是少数粘膜病的罕见部位，胃肠黏膜粘膜霉菌病与高死亡率有关，占所有病例的4-7％。案例报告：我们展示了一个64岁的高血压男子，具有输血依赖性髓细胞增强综合征，在11年前接受肾移植手术。他还正在为铁超负荷带走维护脱绳索。他介绍了右下象限腹痛，恶心，呕吐和非血性腹泻的2天历史。腹部检查揭示了右髂骨中的守卫和5×6cm质量。腹部的CT扫描显示出盲肠质量穿孔的迹象。随着患者不稳定，进行紧急右从素切除术和终体术。手术后，患者被移动到密集护理单元（ICU），并施用广谱抗生素。术后第5天接受的组织病理学检查结果显示了具有大量血管浸润的广泛缺血菌丝，提示粘液菌疾病。两性霉素B开始;然而，在同一天，他的病情恶化，他被搬回了ICU。尽管存在最大的心肺支持，但他有多功能衰竭并死亡。结论：胃肠阳性腺症呈现是非特异性的，诊断通常是晚期或错过的，并且死亡率仍然很高。高临床怀疑，早期诊断和组合的抗真菌和手术治疗是减少死亡率和改善生存的最佳方式。

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