Gastric Mucormycosis Simulated as Phytobezoar in a Patient with Diabetes Mellitus and Chronic Kidney Disease: A Diagnostic Challenge

Abstract

Gastrointestinal mucormycosis is a rare yet life-threatening fungal infection that mostly affects immunocompromised individuals. Gastric involvement is uncommon and usually misinterpreted due to ambiguous clinical presentations and endoscopic findings. A 55-year-old man with diabetes, hypertension, chronic kidney disease, and a history of alternative medication use for prolonged period presented with persistent vomiting, unexplained anemia, and abdominal distension during sepsis and acute illness. Initial imaging indicated stomach wall thickening, and upper gastrointestinal endoscopy revealed an ulcero proliferative growth in stomach but biopsy revealed just chronic gastritis. A big phytobezoar was discovered during a repeat endoscopy following proper stomach preparation. The resected bezoar was histopathologically examined and found wide, aseptate fungal hyphae consistent with mucormycosis. Intravenous Liposomal Amphotericin B (5mg/kg/day) was initiated after histological confirmation. Despite six doses of Liposomal Amphotericin B, the patient developed massive gastrointestinal bleeding (hematemesis and hematochezia), progressive hemodynamic instability and subsequently he died.

Bang. Renal J. 2026; 8(2): 93-98