Pseudomembranous gastritis - A novel complication of Aspergillus infectionin a patient with a bone marrow transplant and graft versus host disease

A 36-year-old Hispanic man who had undergone allogeneic bone marrow transpl antation, complicated by graft versus host disease, was admitted with acute gastrointestinal symptoms, including severe diarrhea and diffuse abdominal pain. He also had a persistent cough with sputum production. Blood culture s yielded Escherichia coli, and sputum cultures grew Apergillus species. Th e patient was treated with antifungal agents and broad-spectrum antibiotics . Despite aggressive medical therapy, the patient died 10 days after admiss ion. Postmortem examination disclosed severe, bilateral confluent bronchopn eumonia, with numerous septated branching hyphae consistent with Aspergillu s species fungal organisms that involved the pulmonary parenchyma and trach eobronchial tree. Although the small and large bowels were only mildly cong ested, the entire gastric mucosa was covered with a 1.5-cm-thick pseudomemb rane that contained numerous Aspergillus organisms. Our report represents t he first description, to our knowledge, of a diffuse inflammatory pseudomem brane in the stomach, a complication that to date has only been associated with small and large bowel involvement.