Co-infection of intestinal tuberculosis and mucormycosis in a patient with Down syndrome: a unique case report with literature review.
Bishal PalKetavath ThirupathaiahBhawana Ashok BadheVishnu Prasad Nelamangala RamakrishnaiahSouradeep DuttaAbhinaya ReddyAnkit JainPublished in: BMJ case reports (2021)
Mucormycosis represents several unusual opportunistic infection caused by saprophytic aseptate fungi. There is a recent rise in cases of mucormycosis due to an increase in diabetic and immunodeficient patients like patients on long-term steroids, immunomodulators due to organ transplantation, malignancies, mainly haematological malignancies, and autoimmunity. Anatomically, mucormycosis can be localised most commonly as rhino-orbito-cerebral followed by pulmonary, disseminated, cutaneous and gastrointestinal, rarest being small intestinal. Patients with Down syndrome are immunodeficient due to their impaired immune response. Disseminated tuberculosis is also common in immunodeficient patients. We report a rare case of small intestinal mucormycosis in a patient with Down syndrome with coexisting intestinal tuberculosis. Due to the invasiveness of mucormycosis, the patient succumbed to death despite providing aggressive surgical debridement and medical management.
Keyphrases
- case report
- newly diagnosed
- ejection fraction
- immune response
- mycobacterium tuberculosis
- prognostic factors
- type diabetes
- healthcare
- stem cells
- rare case
- mesenchymal stem cells
- hiv aids
- dendritic cells
- patient reported outcomes
- inflammatory response
- brain injury
- subarachnoid hemorrhage
- blood brain barrier
- celiac disease