Basidiobolomycosis a mysterious fungal infection mimic small intestinal and colonic tumour with renal insufficiency and ominous outcome

Abstract

Basidiobolomycosis is a rare fungal infection caused byBasidiobolus ranaruma worldwide environmental saprophyte fungus that is potentially a pathogen.B ranarummainly affects the subcutaneous tissues but gastrointestinal and disseminated infections rarely have been reported previously. We report a case ofB ranaruminfection in a 12-year-old immunocompetent boy presented with abdominal pain from 2 months earlier before admission in the hospital. Abdominal CT scan revealed a lobulated mass-like lesion in the vicinity of right lower quadrant enveloping ascending colon and terminal ileum with involvement of mesentery. Histopathological examination showed severe full-thickness infiltration of inflammatory cells mainly eosinophils admixed with multinucleated giant cells and large areas of necrosis with granulomatous feature. Periodic acid Schiff staining demonstrated thin-walled septate fungal hyphae's surrounded by eosinophilic material (Splendore-Hoppeli phenomenon) identified as a basidiobolomycosis.

Gastrointestinal basidiobolomycosis: An emerging mycosis difficult to diagnose but curable. Case report and review of the literature

“…Although a definite diagnosis can be obtained with culture [14,15,18,19,[22][23][24]30,33,35,41,45,47,[49][50][51]54,59,62], it was frequently missed in previous reports because of the lack of suspicion that made tissue specimens unavailable for culture purpose. Therefore, the diagnosis of gastrointestinal infection by B. ranarum was mainly obtained on histologic examination, which typical morphologic features include granulomatous inflammation and a diffuse eosinophilic infiltrate with thin walled branched hyphae surrounded by eosinophilic material (Splendore-Höeppli phenomenon) and sometimes zygospores (spherical bodies with foamy cytoplasm) [4,6,12,16,17,20,24,[26][27][28][29][31][32][33][35][36][37][38][39][42][43][44]46,49,52,53,…”

Diagnosis of gastrointestinal basidiobolomycosis: a mini‐review

“…11 The remaining six patients were one from each of Nigeria, India, Bangladesh, Italy, Netherlands and one with unreported country of origin. 11 The 27 reported paediatric patients are summarised in Table 1, [12][13][14][15][16][17][18][19][20][21][22][23][24] where 19 patients are from KSA, 3 from Iran, 2 from Iraq, 2 from Brazil and 1 from Nigeria.…”

“…Reported paediatric patients of GI basidiobolomycosis [12][13][14][15][16][17][18][19][20][21][22][23][24]. …”

Basidiobolomycosis of Right Colon Mimicking as Carcinoma of Colon

“…2 It produces invasive infection in both immunocompetent and immunosuppressed individuals, is resistant to amphotericin B, and usually mimics carcinoma of the GI tract. [3][4][5][6][7][8][9] Because of its rarity and unfamiliarity to the clinician, it is usually misdiagnosed as carcinoma, inflammatory bowel disease (IBD), tuberculosis (TB), or other fungal infection such as mucormycosis. [3][4][5]7,[10][11][12] We report our experience with this rare entity along with a review of the literature regarding the preferred modality of treatment.…”

“…[3][4][5][6][7][8][9] Because of its rarity and unfamiliarity to the clinician, it is usually misdiagnosed as carcinoma, inflammatory bowel disease (IBD), tuberculosis (TB), or other fungal infection such as mucormycosis. [3][4][5]7,[10][11][12] We report our experience with this rare entity along with a review of the literature regarding the preferred modality of treatment. biopsy specimen failed to demonstrate any malignant tissue or tubercular granuloma.…”