Anwarul Haq, Nadeem Akhter, Ilyas Bader.
Mucormycosis of the gastrointestinal tract in a child: A rare entity.
Int J Pathol Jan ;2(1):42-3.

An 18 months old child presented with 2 months history of fever and abdominal mass. He was treated for enteric fever in another hospital and also received antimalarials but had no relief. He had no symptom of intestinal obstruction. A globular, hard, non-tender, fixed mass about 10x10 cm was palpable in the right hemi abdomen. The clinical impression was that of some tumor, like Neuroblastoma, Nephroblastoma or Lymphoma. Leukocyte Count was 20,000/cmm. Hb was 7g/ dl. ESR was 70. Renal function and Liver function tests were within normal range. Abdominal sonogram was suggestive of an inflammatory mass causing mild hydronephrosis and hydroureter on ipsilateral side. CT scan abdomen showed a soft tissue mass in the right lumbar region inrelation to the gut loops. The impression was again that of an inflammatory mass or lymphoma. Patient was initially treated conservatively with antibiotics but was not settling. He developed symptoms of intestinal obstruction for which an exploratory laparotomy was performed. On laparotomy he had a huge mesenteric mass and matting of gut loops which were also plastered to the abdominal wall. The omentum was also trapped in adhesions. It was not possible to remove the mass so multiple biopsies were taken. Histopathology showed mucormycosis with aseptate hyphae pattern. Mesenteric lymph nodes were reported to have reactive hyperplasia. Patient was put on Amphotericin B. Post operatively the patient developed fecal fistula but was also passing stools per rectum. The fecal fistula was treated conservatively. The child was kept in regular follow up program but he lost follow up after a month. Till such time the output from the fistula was getting reduced and he was on full oral feed. No surgical intervention was done afterwards.

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