Colonic Basidiobolomycosis—An Unusual Presentation of Eosinophilic Intestinal Inflammation

Abstract

Basidiobolomycosis is a rare fungal disease caused by Basidiobolus ranarum. Involvement of the gastrointestinal tract is unusual and poses both a diagnostic and therapeutic challenge, as clinical signs are non-specific and predisposing risk factors are lacking. It can mimick inflammatory bowel disease, primary immunodeficiency, or a malignancy and should be considered in patients who do not respond to standard therapy. We present the case of a 22 months old boy with confirmed colonic Basidiobolomycosis, who presented with severe eosinophilic inflammation of the gastrointestinal tract. Panfungal PCR performed on DNA extracted directly from a tissue sample confirmed the presence of Basidiobolus. He made a full recovery with a combination of surgery and prolonged targeted antifungal medication.

Gastrointestinal Basidiobolomycosis in a 45-Year-Old Woman

“…Anatomically, gastrointestinal basidiobolomycosis most frequently targets the colon. Signs and symptoms of gastrointestinal basidiobolomycosis are largely non-specific during clinical presentation [ 3 ]. Indeed, the lack of specific symptomatology is a major contributing factor to the delayed diagnosis of gastrointestinal basidiobolomycosis [ 3 ].…”

“…Signs and symptoms of gastrointestinal basidiobolomycosis are largely non-specific during clinical presentation [ 3 ]. Indeed, the lack of specific symptomatology is a major contributing factor to the delayed diagnosis of gastrointestinal basidiobolomycosis [ 3 ]. Nonetheless, in descending order, abdominal pain (90%), fever (40%), and abdominal mass (30%) are the most frequently reported complaints.…”

“…It is most often caused by Basidiobolus ranarum , a saprophytic fungus that is affiliated with the Zygomycetes family [ 1 ]. Skin and subcutaneous tissues are the most typically implicated sites of infection [ 2 , 3 ]. Nonetheless, the involvement of the gastrointestinal tract by basidiobolomycosis is exceedingly rare [ 4 , 5 ].…”

Challenging Presentations of Seven Cases of Gastrointestinal Basidiobolomycosis in Sudan: Clinical Features, Histology, Imaging, and Recommendations

“… 4 5 Basidiobolus species is a fungus found in soil and decaying vegetables and also in the intestines of some animals like fish and is endemic in tropical parts of Asia and Africa. 6 7 8 9 10 11 12 13 14 It is well known to cause subcutaneous involvement and it may leads to subcutaneous nodules, lymphedema, and hyperpigmentation in the extremities, buttocks, and back. 4 Most subcutaneous cases are contracted through minor trauma to the skin or a bite of an insect.…”

“…1 Owing to the vague complaints, the provisional diagnosis included inflammatory bowel disease, TB, malignancy, and appendicitis or appendicular mass. 15 Ultrasound and CT scan showed colonic mass 7 9 10 ( Figs. 1 2 ).…”