Gastric Mucormycosis in an Immunocompetent Patient Masquerading as Peptic Ulcer Disease: A Case Report

The present case describes a 42-year-old previously healthy male who presented with two weeks of dull epigastric pain, nausea, and melena. On examination, he was pale but haemodynamically stable. Laboratory evaluation revealed iron deficiency anaemia, while other haematological, renal, and liver parameters were within normal limits. Upper gastrointestinal endoscopy demonstrated two large antral ulcers with irregular margins, necrotic bases, and surrounding mucosal oedema. Histopathology confirmed gastric mucormycosis, showing broad aseptate fungal hyphae with right-angle branching, highlighted by Periodic Acid-Schiff (PAS) and Grocott’s Methenamine Silver (GMS) staining. The patient was treated with intravenous liposomal amphotericin B (5 mg/kg/day) for 21 days, followed by oral posaconazole (300 mg daily) for six weeks. Clinical improvement occurred within 10 days. Followup endoscopy at three months showed complete ulcer healing, and at six months, the patient remained asymptomatic with no evidence of recurrence. The present case emphasises that gastric mucormycosis, although rare, can occur in immunocompetent individuals. Early endoscopic biopsy and prompt initiation of antifungal therapy are crucial, and selected cases may achieve successful outcomes with medical management alone, without surgical intervention.