First culture-proven gastrointestinal entermophthoromycosis in the United States: A case report and review of the literature

Schmidt, James H.; Howard, Richard J.; Chen, Jane L.; Pierson, K. Kendall

doi:10.1007/bf00437168

Cited by 39 publications

(25 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…GI basidiobolomycosis is rare (Bittencourt et al, 1979;Khan et al, 1998), with only 14 cases in adults (Khan et al, 2001;Lyon et al, 2001) and 12 cases in children (Al Jarie et al, 2003;Wasim Yusuf et al, 2003) having been reported worldwide. The reported cases included eight cases from the United States; eight from the Kingdom of Saudi Arabia, four from Brazil, two each from Nigeria and Kuwait, one from Iran and one from the Netherlands (de Aguiar et al, 1980;Schmidt et al, 1986;Pasha et al, 1997;Khan et al, 1998;Smilack, 1998;Yousef et al, 1999;Zavasky et al, 1999;Al Jarie et al, 2003). No specific risk factors were identified for GI basidiobolomycosis, except that three patients had a history of diabetes mellitus (Khan et al, 2001).…”

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

View full text Add to dashboard Cite

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...

show abstract

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

View full text Add to dashboard Cite

show abstract

“…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). The stomach, duodenum, and colon are the primary sites of gastrointestinal involvement, and granulomatous inflammation and fibrosis are limited to the muscularis propria with no vascular invasion in any of the patients (359).…”

Section: Entomophthorales Causing Zygomycosis In Humansmentioning

confidence: 96%

“…The exact reverse of this is true for Conidiobolus and Basidiobolus infections. Disease occurs primarily in normal, immunocompetent hosts (184,442), with relatively few cases currently seen associated with immuncompromise (214,411,486,487).…”

Section: Relationship Of the Entomophthorales To The Mucoralesmentioning

confidence: 99%

Zygomycetes in Human Disease

Ribes¹,

Vanover-Sams²,

Baker³

2000

Clinical Microbiology Reviews

1,093

1,053

View full text Add to dashboard Cite

“…In 1986, the first culture-proven case of GIB in the USA was reported by Schmidt and his colleagues (Schmidt et al, 1986). The patient was a 69-year-old diabetic man with lesions involving the duodenum, ileum, caecum and ascending colon.…”

Section: Clinical Laboratory Imaging and Histopathological Findingsmentioning

confidence: 99%

Gastrointestinal basidiobolomycosis in children: an overlooked emerging infection?

El-Shabrawi

Kamal

2011

Journal of Medical Microbiology

View full text Add to dashboard Cite

First culture-proven gastrointestinal entermophthoromycosis in the United States: A case report and review of the literature

Cited by 39 publications

References 7 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

Gastrointestinal basidiobolomycosis in children: an overlooked emerging infection?

Contact Info

Product

Resources

About