PMC5007338_01
Contrast enhanced CT showing long, inflamed, and retrocaecal appendix with a distal kink. (a) Axial image showing inflamed (enhancing) appendix (proximal part-arrow and tip-arrow head). (b) Sagittal image showing the nonenhancing mid portion of the appendicular wall with kink (arrow) and no periappendicular collection.
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fig1
Findings were corroborated with Computed Tomography (CT) (Figures 1(a) and 1(b)).
Contrast enhanced CT with coronal (a) and sagittal (b) images showing ruptured (arrow) appendix at the distal body with localized periappendicular collection.
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CT now revealed an inflamed appendix with its tip and body replaced with loculated fluid collection, suggestive of perforated appendicitis (Figures 2(a) and 2(b)).
(a) H & E 100x showing necrotic appendicular wall with fungal colonies. (b) H & E 400x showing fungal colonies in the appendix.
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Extensive mucosal ulceration and necrosis were seen in appendicular wall with scattered small and large fungal colonies in mucosa, infiltrating the serosa and periappendicular tissue (Figures 3(a) and 3(b)).
PAS stain confirming colonies of mucormycosis.
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fig4
Broad aseptate hyphae with right angle branching was seen with Periodic acid-Schiff (Figure 4) and Gomori methenamine silver staining (Figure 5).
GMS stain confirming the broad aseptate hyphae of mucormycosis.
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fig5
Broad aseptate hyphae with right angle branching was seen with Periodic acid-Schiff (Figure 4) and Gomori methenamine silver staining (Figure 5).