A Fatal Gastrointestinal Hemorrhage From Colonic Mucormycosis After a Short Course of Steroids: Quality Implications

Abstract

We discuss a fatal infection with colonic mucormycosis in a patient with short-term corticosteroid use and no other form of immunosuppression. The patient was a 75-year-old woman admitted with an acute respiratory decompensation and bilateral pulmonary infiltrates of unclear etiology. When infectious etiologies were ruled out she was started on high-dose corticosteroids. On hospital day 23, the patient developed lower gastrointestinal bleeding and on colonoscopy she was found to have developed colonic ulcerations. Biopsy of these ulcerations demonstrated fungal forms consistent with invasive gastrointestinal mucormycosis. The patient refused surgery and after 10 days of aggressive antifungal therapy, she expired.