S3012 Gastric Mucormycosis; An Infection of Fungal Invasion Into the Gastric Mucosa in Immunocompromised Patients

Primary gastric mucormycosis is a rare but potentially lethal fungal infection due to the invasion of Mucorales into the gastric mucosa. It may result in high mortality due to increased risk of complications in immunocompromised patients. Common predisposing risk factors to develop gastric mucormycosis are prolonged uncontrolled diabetes mellitus with or without diabetic ketoacidosis (DKA), solid organ or stem cell transplantation, underlying hematologic malignancy, and major trauma. Abdominal pain, hematemesis, and melena are common presenting symptoms. The diagnosis of gastric mucormycosis can be overlooked due to the rarity of the disease. A high index of suspicion is required for early diagnosis and management of the disease, particularly in immunocompromised patients. Radiological imaging findings are nonspecific to establish the diagnosis, and gastric biopsy is essential for histological confirmation of mucormycosis. Prompt treatment with antifungal therapy is the mainstay of treatment with surgical resection reserved in cases of extensive disease burden or clinical deterioration. We presented a case of acute gastric mucormycosis involving the body of stomach in a patient with poorly controlled diabetes and chronic renal disease, admitted with acute onset of abdominal pain. Complete resolution of lesion was noted with 16 weeks of medical treatment with intravenous amphotericin B and posaconazole.

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Ultrastructure Research of the Gastritis from Returning Bile

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100158558 ◽

1990 ◽

Vol 48 (3) ◽

pp. 202-203

Author(s):

Shaopeng Hu ◽

Jianhua Wang ◽

Zhen Li ◽

Huei Chen ◽

Fei Cu ◽

...

Keyword(s):

Electron Microscope ◽

Gastric Mucosa ◽

Scanning Electron Microscope ◽

Lamina Propria ◽

Transmission Electron Microscope ◽

Ultrastructural Change ◽

Common Disease ◽

Epithelial Surface ◽

Transmission Electron ◽

Scanning Electron

Gastritis from returning bile is a common disease, but the reason for the disease is not clear. As the pathologic ultrastructure research progresses, it has drawn attention to the ultrastructural change of cells in gastric mucosa by clinical workers. We observed gastric mucosa tissues of 15 patients suffering from gastritis with a transmission electron microscope (TEM) and a scanning electron microscope (SEM). It is the first report in China that fungus exists in the lamina propria of gastric mucosa tissue. The result is as follows.The gastric mucosa tissues of 15 patients suffering from gastritis were acquired by stomachoscopy. Both TEM and SEM specimens were prepared by the usual methods. Under the TEM, the epithelial surface became higher and larger. Mitochondria of the cells were swollen and cristae were disrupted. There were vacuoles in the cells. The nucleus showed disorder, heterochromatin became darker, and nucleolae could be observed.

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Sem Observations in Gastric Mucosa Exposed to Progressive Enzymatic Etching

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s1431927600002531 ◽

1980 ◽

Vol 38 ◽

pp. 570-571

Author(s):

C.A.E. Lemmi ◽

D. Booth ◽

G.E. Adomian

Keyword(s):

Gastric Mucosa ◽

Critical Point ◽

Proteolytic Activity ◽

Etching Process ◽

Cellular Types

In order to enrich populations of homogeneous cellular types we dissociated gastric mucosa by enzymatic techniques. In addition, we used SEM to monitor the progressive etching of the mucosa. Two enzymes were tested: collagenase III with minimum proteolytic activity and Pronase with broader proteolytic effects. The gastric mucosa was exposed to the effect of the enzymes using everted stomach preparations. In this way the digestive action occured progressively from the lumen of the stomach toward the base of the glands. This “etching” process could be monitored conveniently by SEM. After incubation for periods varying from 30 to 210 minutes the tissues were stretched on dental wax, fixed in 2 % glutaralheyde, post-fixed in osmium, dehydrated, critical point dryed and coated with gold. A model MSM-5 “Mini-SEM” was used for observation. Gentle uncurling of the preparation before coating with gold produced fractures which revealed the structure of the gastric glandsin more detail.

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