Gastrointestinal Basidiobolomycosis: An Emerging, and A Confusing, Disease in Children (A Multicenter Experience)

Shreef, Khalid; Saleem, Mervat; Saeedd, Mayssa Adballah; Eissa, Mohamed

doi:10.1055/s-0037-1598104

Cited by 23 publications

(14 citation statements)

References 15 publications

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“…One other patient had the isolation of other fungal species (Candida and Aspergillus ) from the peritoneal fluid but not Basidiobolus. This is consistent with the available literature that reports a low yield from tissue fungal cultures, as low as 50% [ 5 , 8 ]. Waiting for culture confirmation usually takes 4–6 weeks, which could adversely affect the outcome.…”

Section: Discussionsupporting

confidence: 93%

“…GIB has been diagnosed when patients were investigated for abdominal mass to rule out malignancies or inflammatory bowel disease, as seen in other case series in the past [ [1] , [2] , [3] , 8 ]. This signifies how difficult it is to reach the diagnosis without a biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Zabolinejad et al., Al Shanefy et al., and Shreef et al. reported that surgical excision has a pivotal role in treatment [ 1 , 2 , 8 ]. From our series, we found that surgical excision at presentation was not feasible, mainly due to the amalgamated nature of the mass and involvement of multiple loops of small and large bowel.…”

Section: Discussionmentioning

confidence: 99%

“…Some centers have practiced surgical excision of the infected mass in pediatric and adult patients [ 1 , 2 , 8 , 10 ]. In our experience, surgical excision of mass has no role in the treatment of GIB.…”

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal Basidiobolomycosis in pediatric patients

Haq

Rasheedi

Farsi

et al. 2021

International Journal of Pediatrics and Adolescent Medicine

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Introduction Basidiobolomycosis is a rare fungal disease, lately appearing in the gastrointestinal system of pediatric patients. Their clinical presentation resembles that of lymphoma or granulomatous inflammations. This non-specific presentation makes Gastrointestinal Basidiobolomycosis (GIB) a diagnostic challenge. Methods We are reporting the largest series of pediatric GIB, from Saudi Arabia. 12 patients were diagnosed between January 2012 and December 2019, between the ages of 16 months and 8 years. Results The most common symptoms were fever and abdominal pain. Further examination revealed an abdominal mass. Biopsy of the mass was the mainstay of diagnosis, with histological findings of typical filamentous fungal hyphae and zygospores, surrounded by eosinophils. Conclusion Role of surgery was limited to establishing the diagnosis and dealing with complications. Antifungal medication was the cornerstone of treatment in all our patients. Three of our patients were exceptional with complications such as entero-cutaneal fistula, entero-enteric fistula and short bowel syndrome. These complications have not been previously reported. We have discussed the challenges related to their management. The diagnosis of GIB in pediatric patients with abdominal mass, needs a high index of suspicion. We believe outcome depends on the severity of disease, involvement of surrounding tissues and presence of complications at the time of diagnosis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal Basidiobolomycosis in pediatric patients

Haq

Rasheedi

Farsi

et al. 2021

International Journal of Pediatrics and Adolescent Medicine

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“…Remarkably, our patient’s eosinophil count remained normal before and following surgery. Peripheral eosinophilia is observed in 76–94.0% of the cases [1,13,14]. Interestingly, the persistence of peripheral eosinophilia following surgery could indicate an on-going focus of infection and demand further investigation [1].…”

Section: Discussionmentioning

confidence: 99%

Colonic basidiobolomycosis presenting with intestinal obstruction and a normal eosinophil count

Qahtani

Alangari

Mohammed

et al. 2019

IDCases

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Gastrointestinal basidiobolomycosis (GIB), caused by Basidiobolus ranrum , is a rare fungal infection with a limited geographic distribution. The majority of the cases are reported from the warm areas of Arizona in USA, Saudi Arabia and Iran. We report a middle aged patient who was admitted to hospital with suspected metastatic colonic carcinoma. He presented with constipation, anorexia and weight loss. Computed tomography scan disclosed a mass involving the mid and distal sigmoid colon and hypodense lesion in hepatic segment IV. Excised tissue during a Hartmann’s surgery showed an extensive eosinophil-rich transmural inflammation with mural necrotizing granulomas and several broad septated fungal hyphae. He was commenced on voriconazole following surgery. The diagnosis of basidiobolomycosis was established by histopathological examination. Since the diagnosis was not suspected preoperatively tissue culture for fungi was not collected. However molecular testing confirmed the diagnosis of GIB. Therapy involved a combination of surgical resection of the mass and prolonged voriconazole treatment. Increased awareness among physicians is needed for early diagnosis and treatment of GIB.

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Agents of Systemic and Subcutaneous Mucormycosis and Entomophthoromycosis

Garcia‐Hermoso,

Alanio,

Lanternier

et al. 2023

ClinMicroNow

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Mucormycosis and entomophthoromycosis are invasive fungal infections caused by environmental pauciseptate filamentous fungi. Entomophthoromycosis presents as subcutaneous infections with favorable outcome after prolonged azole therapy without surgery, although it is potentially associated with disfiguring lesions. Mucormycosis can develop in HIV‐infected patients and in intravenous‐drug users. The diagnosis of mucormycosis should be considered an emergency, because delaying therapy will affect outcome. One of the major differences between mucormycosis and entomophthoromycosis is that the former occurs mainly in predisposed individuals, whereas the latter occurs mostly in apparently immunocompetent hosts. Culture results should always be interpreted in light of the clinical presentation and along with the results of direct examination and/or histopathology. Therapeutic strategies for basidiobolomycosis and conidiobolomycosis are not standardized because of the lack of clinical trials for these rare infections.

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Gastrointestinal Basidiobolomycosis: An Emerging, and A Confusing, Disease in Children (A Multicenter Experience)

Cited by 23 publications

References 15 publications

Gastrointestinal Basidiobolomycosis in pediatric patients

Gastrointestinal Basidiobolomycosis in pediatric patients

Colonic basidiobolomycosis presenting with intestinal obstruction and a normal eosinophil count

Agents of Systemic and Subcutaneous Mucormycosis and Entomophthoromycosis

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