Gastrointestinal mucormycosis (GIM) is a rare, opportunistic fungal infection with poor prognosis. Clinically, it is difficult to diagnose GIM owing to its nonspecific clinical symptoms and poor suspicion. The estimated incidence of GIM is inaccurate, and most cases are diagnosed accidentally during surgery or upon postmortem examination. GIM usually occurs in patients with immune deficiencies or diabetes. Here, we report two cases of immunocompetent young patients with GIM who had good prognosis after treatment. Compared to other case reports on GIM, our cases had unusual infection sites and no obvious predisposing factors, which make it important to highlight these cases. The first case was that of a 16-year-old immunocompetent boy who was admitted with gastrointestinal bleeding and perforation due to a gastric ulcer. Strategies used to arrest bleeding during emergency gastroscopy were unsuccessful. An adhesive mass was then discovered through laparoscopy. The patient underwent type II gastric resection. Pathological examination of the mass revealed bacterial infection and GIM. The second case was of a 33-year-old immunocompetent woman with a recent history of a lower leg sprain. The patient subsequently became critically ill and required ventilatory support. After hemodynamic stabilization and extubation, she presented with hematemesis due to exfoliation and necrosis of the stomach wall. The patient underwent total gastrectomy plus jejunostomy. The pathology results revealed severe bacterial infection and fungal infection that was confirmed as GIM. The patient fully recovered after receiving anti-infective and antifungal treatments. Neither patient was immunosuppressed, and both patients presented with gastrointestinal bleeding. GIM was confirmed via pathological examination. GIM is not limited to immunocompromised patients, and its diagnosis mainly relies on pathological examination. Early diagnosis, timely surgical treatment, and early administration of systemic drug treatment are fundamental to improving its prognosis.

中文翻译：

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毛霉菌病致免疫正常患者上消化道溃疡穿孔2例报告

胃肠道毛霉菌病 (GIM) 是一种罕见的机会性真菌感染，预后不良。临床上，GIM临床症状不特异，疑点重重，难以诊断。GIM 的估计发病率是不准确的，大多数病例是在手术过程中或在尸检时意外诊断出来的。GIM 通常发生在免疫缺陷或糖尿病患者身上。在这里，我们报告了两例免疫功能正常的 GIM 年轻患者，他们在治疗后预后良好。与 GIM 上的其他病例报告相比，我们的病例具有不寻常的感染部位且没有明显的诱发因素，因此突出这些病例非常重要。第一个病例是一名 16 岁免疫功能正常的男孩，因胃溃疡导致胃肠道出血和穿孔入院。用于在紧急胃镜检查期间阻止出血的策略是不成功的。然后通过腹腔镜检查发现了一个粘性肿块。患者接受了 II 型胃切除术。肿块的病理检查显示细菌感染和 GIM。第二个病例是一名 33 岁免疫功能正常的女性，近期有小腿扭伤史。患者随后病情危重，需要通气支持。在血流动力学稳定并拔管后，她因胃壁剥脱和坏死而出现呕血。该患者接受了全胃切除术加空肠造口术。病理结果显示严重的细菌感染和真菌感染，被证实为GIM。患者在接受抗感染和抗真菌治疗后完全康复。两名患者均未受到免疫抑制，两名患者均未出现胃肠道出血。GIM 经病理检查证实。GIM 不仅限于免疫功能低下的患者，其诊断主要依靠病理学检查。早期诊断、及时手术治疗、早期全身药物治疗是改善预后的基础。