Twin Tales of Rarity: Sarcina Ventriculi and Colonic Mucormycosis with Unusual Gastrointestinal Presentations

Abstract

Sarcina ventriculi and mucormycosis are rare but clinically significant infections that can present as unusual gastrointestinal pathologies. Sarcina ventriculi is a gram-positive, anaerobic coccus associated with delayed gastric emptying, gastric ulcers, emphysematous gastritis, and perforation. Due to its nonspecific symptoms and difficulty in culturing, diagnosis often depends on histopathological identification of characteristic tetrad-forming cocci. Mucormycosis, caused by fungi of the order Mucorales, is an aggressive, angioinvasive infection affecting immunocompromised individuals. Gastrointestinal involvement is rare and frequently misdiagnosed due to overlapping clinical features with malignancy. Histopathology remains the gold standard, revealing broad, aseptate hyphae with right-angle branching and vascular invasion. We present two rare cases: a 39-year-old male with duodenal and antral ulcers harbouring Sarcina ventriculi, and a 43-year-old male with colonic mucormycosis showing extensive necrosis and fungal angioinvasion. These cases emphasize the pivotal role of histopathological examination in diagnosing uncommon gastrointestinal infections and highlight the need for clinical vigilance in atypical presentations.