A rare cause of ischemic gut: A case report

•Mucormycosis is a rare cause of vascular obstruction, which can result in gastrointestinal ischemia.•Total gastric infarction is rare but can be a result of extensive fungal invasion of the gastric vasculature.•Mucormycosis is a condition that should be considered in immunocompromised patients.•Early surgical intervention should be considered as anti fungal treatment may not be adequate in the treatment of mucormycosis infection.

IntroductionMucormycosis is a fungal infection that is a rare cause of gastrointestinal ischemia, usually found in the immunocompromised or patients with extended surgical intensive care unit stay. This case report brings to light the rare presentation of a total gastric infarction secondary to a rare fungal infection where the overall outcome of the patient depends on timely diagnosis and management.Case presentationAn elderly Malay female patient in our institution developed severe sepsis. Radiological investigations revealed an intra abdominal source of sepsis likely secondary to total gastric ischemia. Both the abdominal X-ray and computed tomography scan showed evidence of gastric pneumotosis. She was diagnosed with gastric ischemia and underwent a total gastrectomy. However post surgically she continued to deteriorate and passed away 5 days later.ConclusionRecognition of mucormycosis infection is pertinent to commence anti fungal treatment early with timely implementation of subsequent surgical management. Early access to surgery is necessary to improve cure rates in patients with mucormycosis as antifungal treatment alone is usually not adequate for cure.