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EndoTODAY 내시경 교실

[Mucormycosis. 털곰팡이증] -

1. Introduction

Mucoraceae are ubiquitous fungi that are commonly found in soil or in decaying matter, but disease is unusual because of the low virulence of the organisms, which mainly affect immunocompromised individuals (eg, poorly controlled diabetes, glucocorticosteroid use, neutropenia in the setting of hematological or solid malignancy, transplantation, and burns). Infection usually follows local exposure, and most common is disease of the facial sinuses. Ingestion of conidia leads to GI disease that most commonly affects the stomach, ileum, and colon. Once spores begin to grow, fungal hyphae invade tissue and blood vessels, producing thrombosis, infarction, and necrosis. Gl mucormycosis range from colonization of peptic ulcers to infiltrative disease. Invasion must be distinguished from colonization. Treatment with iv amphotericin B or oral posaconazole surgical intervention should be considered for uncontrollable gastrointestinal hemorrhage or perforation.

2. Representative case

60대 여성입니다. 직장암에 대한 palliative RT와 폐암에 대한 항암치료를 받던 환자의 상부위장관 출혈입니다. 식도 조직검사는 herpetic esophagitis와 mucormycosis가 위는 mucormycosis가 나왔습니다. 치료 후 호전되는 모습입니다.

Initial EGD

3 weeks later

8 weeks later

[More cases]

Korean J Gastroenterol 2016

대한상부위장관헬리코박터학회지 2017년

© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.