Basidiobolomycosis: An Emerging Fungal Infection of the Gastrointestinal Tract in Adults

Abstract

Basidiobolomycosis is an unusual fungal infection known for dermatological manifestations that affect immunocompetent young adult and rarely involves the gastrointestinal tract, during the past decade many cases have been reported in Saudi Arabia with diagnosis of gastrointestinal basidiobolomycosis, most of the reported cases were in children and majority came from southern region of Saudi Arabia and all were misdiagnosed initially as either IBD or granulomatous diseases or malignancy. GIB poses diagnostic difficulties due to nonspecific presentations and rarity and has been scarcely reported in medical literatures. GIB might be a life threatening infection. So, a high index of suspicion is warranted in any child or young adult with differential diagnosis of IBD, granulomatous disease and malignancy affecting GI tract especially those patients whom are residents in or came from southern region of Saudi Arabia. In this series which is the largest reported series in adult patient with GIB in this country, we describe 4 cases of GI basidiobolomycosis from southern Region of Saudi Arabia.

Entomophthoromycosis: a challenging emerging disease

“…Misdiagnosis usually delays the definitive diagnosis and subsequently proper management which increases disease morbidity and mortality. Therefore, GIB should be considered in the differential diagnosis of any GI mass with subacute onset of abdominal pain, fever and weight loss particularly when eosinophilia is present …”

“…1, shows Basidiobolus ranarum on Sabouraud's dextrose agar (SDA) culture. 32 The specimen preferred for diagnosis is a biopsy rather than pus, as the chances of positive potassium hydroxide preparation and culture are better with tissue specimens. 7 In tissue sections, entomophthoromycotina are easily differentiated from other fungi by their characteristic hyphal morphology.…”

“…Therefore, GIB should be considered in the differential diagnosis of any GI mass with subacute onset of abdominal pain, fever and weight loss particularly when eosinophilia is present. 28,32…”

Surgical management of colonic basidiobolomycosis among adolescent and adult patients: presentation and outcome

“…Moreover, in the last decade there has been a surge in the reporting of new cases due to an increased awareness of the disease among medical staff and the inclusion of fungal culture in the list of investigations of suspicious cases [6,[13][14][15][16]22,23]. The largest number of reported cases came from the southern region of Saudi Arabia [15,20,23]. This finding may be explained by the nature of the environment in southern Saudi Arabia, which is warm and humid and considered optimal for fungal growth.…”

A Case of Subcutaneous and Gastrointestinal Basidiobolomycosis in Singapore

“…GIB is not commonly reported in the literature and the total reported cases since 1964 till end 2014 were 52 cases worldwide [5][6][7][8][9]. Most cases were from areas with tropical and subtropical climates, mainly Africa and Asia.…”