PMC9997857_01
Sinonasal biopsy showing non-pigmented, pauciseptate ribbon-like hyphae with right angle branching. The morphological features are most consistent with mucorales genera. Periodic acid Schiff (left image) and Grocott methenamine silver (right image) special stains x 600
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F1
A sinonasal biopsy was obtained, and its histopathological examination showed positive GMS stain for fungus, suggestive of mucormycosis [Figure 1].
Huge gastric corpus ulcer with stigmata of recent bleeding covered by necrotic-looking tissue over the greater curvature with abnormal mucosa underneath and nonbleeding visible vessel seen, a hemoclip was placed
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F2
The upper GI endoscopy revealed severe erythematous gastritis and a huge gastric ulcer covered by necrotic-looking tissues with non-bleeding visible vessel, which was clipped [Figure 2].
Severe pale mucosa with ischemic changes noted in the rectosigmoid area
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F3
Sigmoidoscopy revealed pale mucosa, with ischemic changes 18-25 cm from the anal verge [Figure 3], following which biopsies were obtained.
(a and b) Numerous fungal microorganisms in the form of single and clustered, small (1-10mu) narrow-based budding yeasts admixed with a fibrinous exudate in the ulcerated gastric (a) and rectal (b) mucosae with morphological features most consistent with cryptococcus species. (a) Periodic acid Shciff (PAS) stain, x600, (b) Grocott methenamine silver (GMS) stain, x600
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F4
Schiff (PAS) and Grocott methenamine silver (GMS) special stains demonstrated numerous fungal microorganisms in the form of single and clustered small (2-10 mum) narrow-based budding yeasts in ulcerated gastric and rectal mucosa, suggestive of cryptococcus species [Figure 4a and b]. Specific stains such as Fontana-Masson or mucicarmine stain were not available, and the tissues were not sent for microbiological cultures.