Review for 10.1186/s12876-021-01846-x (2021)

Reviewer’s report
Title: 
Mucormycosis Causing Massive Lower Gastrointestinal Bleeding: A Case
Report
Version: 
0 
Date: 
13 Apr 2021
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
RELEVANCE - Does this case report make a contribution to medical
knowledge, have educational value, or highlight the need for a change in clinical
practice or diagnostic/prognostic approaches? 
Yes, this report contributes to medical knowledge
CASE DESCRIPTION - Are the details of the case sufficiently well described to
understand the patient's symptoms and course of treatment? 
Yes, the description of the case is sufficient
DIAGNOSIS/INTERPRETATION - Based on the facts presented, are the
diagnosis, interpretation, and course of treatment medically sound?
Yes, the work described is medically sound
DISCUSSION OF THE CASE - Does the discussion appropriately analyse the
importance of the findings and their relevance to future understanding of disease
processes, diagnosis or treatment? Has an adequate literature review pertinent to
the case been included?
Yes, the case is discussed fully in the context of the literature
OVERALL MANUSCRIPT POTENTIAL - Could an appropriately REVISED
version of this work represent a technically sound contribution?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: What is your overall impression of the report? 
This is a rare presentation of mucormycosis but in immunocompromised patients
maybe it should take a more prominent t role in the differential diagnosis of Gi
symptoms. Therefore this is a great learning case for hospital physicians, the
literature review and discussion is really quite good and focused
Are you confident in the authors' description and interpretation of the report? 
Yes the case is well described 
Have the authors clearly outlined the need for publication by novelty of the case
or the specific adverse event? 
The novelty of the case presentation and the excellent literature
review/discussion are very positive aspects of this journey usual case report
REQUESTED REVISIONS: 
Suggested changes 
1. Line 59 you provide a reference for the other infectious causes but not for
mucoycosis. Why? Without a reference the reader may think there are no papers
I would add at least one reference
2. This is also pertinent on the next paragraph where you really do need a few
references in the first sentence lines 65-66 and in the second sentence lines 67-
78 and line 79 because you are referring to discrete complications.
3. Line 85 was his arterial ph really 6.6? That is incredibly hard to believe-sorry
if this was a venous ph I would leave it out. 
4. Line 88 I am most used to lactate levels reported as mmol/L 
5 lines 157-158. Why would your suspect mucomucosis ? In what clinical
situations? While I understand why if you did suspect it that prophylactic anti
fungal treatment is indicated BUT what are the clinical signs that would lead you
to suspect it? Findings on colonoscopy or UGI endoscopy? When I look at lines
179-181 to treat every immunocompromised patient with lower GI bleeding with
anti fungal meds seems a bit far fetched
6. Line 144 how long did the pathology report take to come back after the
colonoscopy?
7. Lines 105-106 did you do a colonic prep? If not why did you wait until the
next day with such a massive bleed?
ADDITIONAL REQUESTS/SUGGESTIONS: 
see above
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