Gastrointestinal basidiobolomycosis, an emerging infection in the immunocompetent host: a report of 14 patients

Abstract

Zygomycosis is characterized by tissue invasion with broad, non-septate hyphae of species such as Rhizopus, Rhizomucor, Lichtheimia (Absidia) and Basidiobolus. Basidiobolus ranarum usually causes subcutaneous infection, and gastrointestinal manifestations in immunocompetent patients have rarely been reported. It is difficult to diagnose gastrointestinal basidiobolomycosis because of the non-specific clinical presentation and the absence of a definite risk factor. This study identified 14 cases of gastrointestinal basidiobolomycosis, all of which were diagnosed after surgery by characteristic histopathological findings. Diagnosis of this disease requires a high index of suspicion in patients presenting with abdominal symptoms, fever, gastrointestinal mass and eosinophilia accompanied by a high erythrocyte sedimentation rate.

Eosinophilic granulomatous gastrointestinal and hepatic abscesses attributable to basidiobolomycosis and fasciolias: a simultaneous emergence in Iraqi Kurdistan

“…The reported cases of GI basidiobolomycosis nearly all had large or small intestinal obstruction that required surgery [19,29]. The recommended treatment is surgical removal of the infected tissues and an imidazole as anti-fungal agent with itraconozole being the most frequently recommended [16,19,36].…”

“…The largest numbers of cases came from the desert climates of Saudi Arabia (11 patients) and Arizona in the Southwestern United States (17 patients), but four patients each were reported from Brazil and Iran and single patients from Nigeria, India, Bangladesh, Italy, the Netherlands, and an unknown country [16-19]. Recently, 14 additional patients were reported from Shiraz, Iran, a city with a climate and geography similar to Sulaimaniyah [29]. The fungus occurs worldwide, and in the tropics, subcutaneous eosinophilic abscesses due to the traumatic inoculation of basidiobolomycosis are well recognized [16].…”

Colonic basidiobolomycosis with liver involvement masquerading as gastrointestinal lymphoma: a case report and literature review

“…It is caused by B. ranarum, which infects immunocompromised patients and is an opportunistic pathogen in immunocompetent individuals It is unclear how the fungus is introduced into the host's gastrointestinal tract, but it may occur through ingestion of contaminated soil, food, or exposure to animal feces 4 . Alternatively, it may be a zoonotic fungus 7,8 .…”

Basidiobolomycosis a mysterious fungal infection mimic small intestinal and colonic tumour with renal insufficiency and ominous outcome

“…B ranarum is a member of the zygomycetes and subphylum Entomophthoromycotina 1–19. In the past GI involvement was rarely reported 4 – 6. Disseminated basidiobolomycosis, a least common form, also was reported with high mortality rate 3.…”