Cecum Necrosis with Terminal Ileum Perforation Due to Invasive Fungal Infection in a Patient with Diabetes Mellitus and Acute Myeloid Leukemia: A Case Report

Immunosuppression conditions are the leading risk factors for opportunistic fungal infections. The clinical manifestation is related to the site of infection. Gastrointestinal (GI) mucormycosis is a rare form of this disease, even in immunosuppressed patients.

We report rare cecum necrosis with terminal ileum perforation resulting from infiltration of mucormycosis in the cecum wall and terminal ileum mesentery in a patient with diabetes mellitus and acute myeloid leukemia (AML). During chemotherapy for AML, the patient presented diarrhea followed by constipation, severe progressive abdominal pain, and fecaloid peritonitis. Perforation of the terminal ileum was observed during the surgery. Ileostomy, right hemicolectomy, and resection of necrotic tissue were performed, and bowel mucormycosis was confirmed on histologic examination. Unfortunately, the patient expired five days after surgery.

Gastrointestinal mucormycosis is an uncommon infection with symptoms like abdominal pain, nausea, vomiting, and melena. The mortality of GI involvement is due to perforation, peritonitis, and GI bleeding.