Piot D, Gathe J, Bonefas E, Clemmons J, Garland J; International Conference on AIDS.
Int Conf AIDS. 1996 Jul 7-12; 11: 299 (abstract no. Tu.B.2199).
Houston, Texas. Fax: (713)524-4759.
Objective: To describe to our knowledge the first case of Zygomycosis of the cecum in a person with AIDS. Methods: Retrospective case review of a patient followed prospectively by the authors. Results: A 46 y/o male with a CD4 cell count of 10 was admitted because of Fever of Unknown Origin (temp 100 -101 degrees F) and abdominal pain for greater than 6 months. Right lower quadrant tenderness with mild rebound was noted on exam. An abdominal ultrasound revealed fluid collection around the cecum suspicious for an appendiceal abscess. CT scan confirmed an inflammatory process in the cecum suspicious of but not diagnostic of appendicitis. A colonoscopy revealed a friable cecal mass that was felt to be a tumor. A right hemicolectomy with ileotransverse anastomosis was performed, with findings of a large 7.6cm mass involving the entire cecum with evidence of perforation. Histopathology revealed multiple aseptate hyphae in a background of necrosis, with cultures positive for Rhizopus sp. The patient was treated successfully by surgical resection and 19 days of Amphotericin B. He died 18 months later of other AIDS related complications with no evidence of Rhizopus infection seen at autopsy. Conclusions: 1. While Zygomycetes infection of other systems have been reported in AIDS patients, we present the first involving the colon. 2. Histopathology would suggest this disease was blood borne, though we cannot rule out direct ingestion of the organism. 3. Local resection and Amphotericin B was curative 4. Zygomycosis should be considered in the differential diagnosis of GI mass lesions in patients with AIDS.
Publication Types:
Keywords:
- Abdominal Pain
- Abscess
- Anastomosis, Surgical
- Appendicitis
- Cecum
- Colectomy
- Colon
- Colonoscopy
- Diagnosis, Differential
- Digestive System Surgical Procedures
- Humans
- Male
- Necrosis
- Tomography, X-Ray Computed
- Zygomycosis
- radiography
- surgery
Other ID:
UI: 102218303
From Meeting Abstracts