Entomophthoromycosis due to Basidiobolus in Somalia

Antonelli, M.; Vignetti, P; Dahir, Mohamed; Mohamed, Mohamed Said; Favah, A.Abdi

doi:10.1016/0035-9203(87)90209-4

Cited by 16 publications

(15 citation statements)

References 6 publications

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“…Basidiobolomycosis is usually a subcutaneous infection that affects mostly young males, and it is transmitted through traumatic inoculation (Sugar, 2005). Most cases have been reported from tropical and subtropical regions (Antonelli et al, 1987;Kwon-Chung & Bennett, 1992). The visceral form of infection is rare (Kwon-Chung & Bennett, 1992).…”

Section: Discussionmentioning

confidence: 99%

“…It is most common in young children as a disease of the skin and subcutaneous tissues, involving the thighs and buttocks (Bigliazzi et al, 2004). Most cases have been reported in tropical and subtropical climates, mainly in Indonesia and East and West Africa (Antonelli et al, 1987;de Leó n-Bojorge et al, 1988;Bittencourt et al, 1991;Scholtens & Harrison, 1994;Sugar, 2005). GI basidiobolomycosis is exceedingly rare (Centers for Disease Control and Prevention, 1999;Yousef et al, 1999;Zavasky et al, 1999;Khan et al, 2001;Lyon et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gastrointestinal basidiobolomycosis: an emerging fungal infection causing bowel perforation in a child

El-Shabrawi

Kamal

Jouini

et al. 2011

Journal of Medical Microbiology

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Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal (GI) tract. We report a 10-year-old boy diagnosed as suffering GI basidiobolomycosis after being misdiagnosed first as suffering intestinal malignancy then schistosomiasis. The patient presented with fever, abdominal pain, vomiting, abdominal tenderness and rigidity with marked blood eosinophilia. Abdominal ultrasonographic and computed tomographic scans revealed a large caecal mass. Biopsy of the mass showed transmural granulomatous inflammation interpreted as schistosomal granuloma, ruling out lymphoma. The patient's condition deteriorated despite anti-schistosomal therapy. Emergency surgery was then performed, and caecal perforation was found. The mass was excised; cultures were negative and histopathological examination was suggestive of schistosomal granuloma. The mass recurred 3 weeks post-operatively. Secondopinion histopathological examination diagnosed Basidiobolus ranarum infection. Treatment with itraconazole produced marked improvement, with diminution of the mass. B. ranarum was unequivocally identified in the archival formalin-fixed and paraffin-embedded (FFPE) tissue by PCR. This case emphasizes the need to consider GI basidiobolomycosis in children presenting with fever, abdominal mass and eosinophilia, especially those complicated by bowel perforation. IntroductionBasidiobolus species are filamentous fungi that belong to the order Entomophthorales. Unlike other fungi (e.g. Mucorales) classified to the former zygomycetes, they cause subcutaneous zygomycosis in healthy individuals (Singh et al., 2008). Basidiobolus ranarum was first described as an isolate from frogs in 1886. It was cultured from frogs' intestinal contents and excreta (Ribes et al., 2000). It is commonly found in soil and decaying vegetable matter. It is occasionally present as a commensal in the gastrointestinal (GI) tracts of amphibians, reptiles, fish and mammals such as frogs, toads, turtles, fish, chameleons, horses, dogs and bats (Kaufman et al., 1990;Zahari et al., 1990;Gugnani, 1999). The micro-organism was first isolated in 1955 from decaying plants in the United States. Subsequently it was found in soil and vegetation worldwide (Greer & Friedman, 1966). Basidiobolus is endemic in Uganda and certain other areas of Africa, and in parts of Asia including India (Ribes et al., 2000). In the past, clinical isolates of Basidiobolus were classified as B. ranarum, B. meristosporus and B. haptosporus. However, recent taxonomic studies based on antigenic analysis, isoenzyme banding and restriction enzyme analysis indicate that all human pathogens belong to B. ranarum. In two studies, B. ranarum was commonly isolated from South India (Khan et al., 2001;Sujatha et al., 2003).Zygomycosis is characterized by tissue invasion with broad, non-septate hyphae of fungal species such as Rhizopus, Rhizomucor, Absidia and Basidiobolus. Fungal elements of B. ranarum include hyphae and zygospores (Hocquet, 1979;Gugnani, 1999). The hyphae are thin-wall...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gastrointestinal basidiobolomycosis: an emerging fungal infection causing bowel perforation in a child

El-Shabrawi

Kamal

Jouini

et al. 2011

Journal of Medical Microbiology

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“…In addition to chronic subcutaneous disease reported worldwide (20 (41,110,359). These infections have been reported primarily in healthy patients (four of five cases), but in one case the patient was diabetic and anergic (110,411).…”

Section: Entomophthorales Causing Zygomycosis In Humansmentioning

confidence: 97%

“…Additional cases were also identified in India, England, Burma, and Iraq (87). Since Clark's report (87), additional cases have been reported in Africa (20,62,68,87,311,480,505), India (104,223), South America (primarily Brazil) (41), Thailand (80,211,459), Infect. Dis., abstr.…”

Section: Entomophthorales Causing Zygomycosis In Humansmentioning

confidence: 99%

Zygomycetes in Human Disease

Ribes¹,

Vanover-Sams²,

Baker³

2000

Clinical Microbiology Reviews

1,093

1,053

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“…It is most common in young children as a disease of the skin and subcutaneous tissues, involving the thighs and buttocks. Most cases have been reported in tropical and south-tropical climates, mainly in Indonesia and East and West Africa (1,2,5,6,18).…”

Section: Case Reportmentioning

confidence: 99%

Disseminated Basidiobolomycosis in an Immunocompetent Woman

Bigliazzi¹,

Poletti²,

Dell'Amore³

et al. 2004

J Clin Microbiol

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Basidiobolomycosis is a chronic subcutaneous infection of the trunk and limbs due to Basidiobolus ranarum.The disease is well known in tropical areas, although recent cases of gastrointestinal basidiobolomycosis have also been reported in Arizona. We describe a young immunocompetent women who had presented with eosinophilia and lung infiltrates. She subsequently died, and diagnosis of disseminated basidiobolomycosis was made on the basis of histological features at autopsy. CASE REPORTA nonsmoking, 40-year-old housewife was admitted to the hospital with sudden acute dyspnea and hypotension; she died a few minutes after admission to the emergency room due to cardiorespiratory arrest.Three days before, the patient noted the appearance of shortness of breath; hard subcutaneous and painless swellings localized to the back of the shoulders and arms were also noted. For 4 months she had been monitored as an outpatient with low-grade fever and increasing eosinophilia (white cell counts were 13.800 and then 28.280; eosinophils, 11% and then 30%), an elevated erythrocyte sedimentation rate (43 mm/h) and C-reactive protein (3.9 mg/dl), and increased immunoglobulin E (2,583 kU/liter). At that time, pulmonary function tests documented airflow obstruction and chest radiographs revealed a right upper lobe infiltrate. The oxygen saturation was 98% while on room air. Laboratory tests, including percentage of lymphocytes and total count of peripheral blood, hepatitis B virus and hepatitis C virus serological markers, and human immunodeficiency virus status, didn't reveal any form of immunosuppression. She did not suffer from diabetes mellitus or peptic ulcer disease. Symptoms persisted despite antibiotics (macrolide, penicillin-cephalosporin), inhaled corticosteroids, and long-acting ␤2 agonist treatment.A high-resolution computed tomography showed patchy subpleural infiltrates with a halo sign in the right lung (Fig. 1). Enlarged mediastinal lymph nodes, right pleural effusion, and two cysts in the liver were also detected. Bronchoscopy documented a nodular submucosal infiltration involving the distal trachea and proximal right bronchial system.Mucosal biopsies from the right main bronchus showed only eosinophil infiltration and necrosis. There were no organisms, granulomas, or evidence of neoplasm. Subsequently a surgical lung biopsy was taken from the middle right lobe. The histologic findings were similar to those of the transbronchial biopsy: eosinophil infiltration and necrosis with no organism identified. Skin biopsy from subcutaneous nodules, performed 1 day before death, showed eosinophilic panniculitis, in which scattered hyphal elements were present.Autopsy report. The macroscopic examination revealed necrotic small white-yellow opacities (3 to 4 mm in diameter) in the pericardium, parietal pleura of the right hemithorax, visceral surface of the right lung, liver, spleen, kidneys, adrenal glands, pancreas, uterus and peritoneum; the stomach presented fungating necrotic mucosal lesions. Small yellowish nonulcerated nod...

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Entomophthoromycosis due to Basidiobolus in Somalia

Cited by 16 publications

References 6 publications

Gastrointestinal basidiobolomycosis: an emerging fungal infection causing bowel perforation in a child

Gastrointestinal basidiobolomycosis: an emerging fungal infection causing bowel perforation in a child

Zygomycetes in Human Disease

Disseminated Basidiobolomycosis in an Immunocompetent Woman

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