Emphysematous gastritis associated with mucormycosis in a patient with fulminant myocarditis requiring veno-arterial extracorporeal membrane oxygenation

We present the case of a 37-year-old male who was admitted to our hospital with fever, weakness, limb pain for six days and dyspnea for 14 hours. The patient had no immune related diseases and was rapidly diagnosed with fulminant myocarditis, which progressed to severe cardiogenic shock during the early stage. Subsequently, he was treated with V-A extracorporeal membrane oxygenation (ECMO). It is worth mentioning that the patient's peripheral blood was taken for metagenomic next-generation sequencing (mNGS) upon admission and the results did not find any pathogenic bacteria. However, there was no further examination (such as coronary angiography and myocardial biopsy) to determine the etiology of myocarditis.