Postmortem Diagnosis of Fatal Gastric Mucormycosis in a Young Male

Abstract

Background: Gastric mucormycosis is a rare and highly aggressive fungal infection, typically seen in immunocompromised individuals. Its nonspecific clinical presentation often leads to delayed diagnosis and poor outcomes. Pediatric cases, particularly without clear risk factors, are exceedingly uncommon.

Case Presentation: We report the postmortem diagnosis of gastric mucormycosis in a 13-year-old male who presented with undifferentiated fever and altered consciousness. The patient died before a definitive diagnosis could be made. Autopsy revealed significant gastric mucosal necrosis and ulceration. Histopathological examination with PAS and GMS stains demonstrated broad, non-septate, angioinvasive fungal hyphae with intravascular thrombosis—hallmarks of mucormycosis. No fungal involvement was found in other organs, suggesting primary gastric infection.

Discussion: This case highlights the diagnostic challenge of gastric mucormycosis, particularly in a young, seemingly immunocompetent host. While commonly associated with diabetes, malignancy, or immunosuppression, our patient lacked overt predisposing factors, though borderline low blood counts suggested a possible undiagnosed immunocompromised state. The aggressive course and fatal outcome underscore the importance of maintaining a high index of suspicion in atypical presentations.

Conclusion: Gastric mucormycosis, though rare, should be considered in unexplained systemic deterioration, even in young patients without clear risk factors. Early diagnosis through histopathology remains critical for timely, life-saving intervention.