Invasive Gastrointestinal Basidiobolus Ranarum Infection in an Immunocompetent Child

Yusuf, Noshin Wasim; Assaf, Hasan M.; Rotowa, N. A.

doi:10.1097/01.inf.0000054020.84508.02

Cited by 19 publications

(12 citation statements)

References 10 publications

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“…There are also a few cases described in the literature that showed a successful outcome with antifungal treatment alone [33][34][35]42,56,61]. The role of amphotericin B has been overcome since resistance has been observed in more than 50% of cases [25]. Potassium iodide (KI) has been traditionally used for the treatment of subcutaneous basidiobolomycosis and more recently it was employed successfully in a single case report of a child with GIB [21,66,67].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal basidiobolomycosis: An emerging mycosis difficult to diagnose but curable. Case report and review of the literature

Pezzani

Cristo

Parravicini

et al. 2019

Travel Medicine and Infectious Disease

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Background: Gastrointestinal basidiobolomycosis (GIB) is a rare mycosis affecting almost exclusively immunocompetent subjects. Methods: We describe a case of GIB caused by Basidiobolus ranarum in a 25-year-old Italian immunocompetent man resident in Ireland who presented a 2-month history of epigastric pain. Suspecting colon cancer he underwent a right hemicolectomy subsequently leading to a diagnosis of GIB by means of molecular biology. After surgery a 9-month therapy with itraconazole was employed with a good outcome. A review of medical literature regarding GIB cases published in the period 1964-2017 is presented. Results: One-hundred and two cases of GIB were included in this analysis. The disease was observed predominantly in male gender (74.5%) and children (41.2%). Abdominal pain was the single most common complaint (86.3%) followed by fever (40.2%) and evidence of an abdominal mass (30.4%). Peripheral blood eosinophilia was detected in 85.7% of cases. Most of the patients were diagnosed in Saudi Arabia (37.2%) followed by USA (21.6%) and Iran (20.6%). Surgery plus antifungal therapy was employed in the majority of patients (77.5%). An unfavourable outcome was documented globally in 18.6% of patients. Conclusions: GIB seems to be an emerging intestinal mycosis among immunocompetent patients living in the Middle East and Arizona. 1 MDP and VDC contributed equally to this work.

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal basidiobolomycosis: An emerging mycosis difficult to diagnose but curable. Case report and review of the literature

Pezzani

Cristo

Parravicini

et al. 2019

Travel Medicine and Infectious Disease

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“…Gastrointestinal basidiobolomycosis is rare with only 13 cases reported worldwide in adults [ 2 , 3 ] and 10 in children. [ 4 , 5 ]. Only a few cases of retroperitoneal [ 6 - 8 ] or pulmonary [ 9 ] basidiobolomycosis have been reported.…”

Section: Introductionmentioning

confidence: 99%

A fatal pseudo-tumour: disseminated basidiobolomycosis

et al. 2006

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BackgroundBasidiobolomycosis is a rare disease caused by the fungus Basidiobolus ranarum, member of the class Zygomycetes, order Entomophthorales, found worldwide. Usually basidiobolomycosis is a subcutaneous infection but rarely gastrointestinal manifestations have been described; 13 adults and 10 children and a few retroperitoneal or pulmonary cases. In gastrointestinal basidiobolomycosis the colon is most frequently involved, usually presenting with subacute mild abdominal pain. In contrast to children only very few described adult patients had hepatic masses. Definitive diagnosis requires culture, serological testing can be helpful. The fungal morphology and the Splendore-Hoeppli phenomenon are characteristic histological features. There are no prominent risk factors. Usually surgery and prolonged antifungal therapy are required.Case presentationA 61 year old man presented with progressive left abdominal pain and constipation since a few months. Colonoscopy showed an obstructing tumour in the descending colon, and a hemicolectomy was performed. Histology showed inflammation, possibly caused by a fungal or parasitic infection, without definite identification of an organism. A few weeks postoperatively a CT scan made because of abdominal discomfort, revealed a livermass (6 cm). Treatment with metronidazole, directed against an amoebic liver abscess, was unsuccessful. He developed a marked eosinophilia (27.7%). A liver biopsy was performed and the patient was referred to a university hospital.A repeated CT scan showed a livermass of 9 cm diameter. Review of colon and liver biopsy samples showed extensive necrosis and histiocytes, multinucleated giant cells and numerous eosinophils. Grocott stained sections contained unusually large hyphae surrounded by strongly eosinophilic material in haematoxylin and eosin stained sections (Splendore-Hoeppli phenomenon). A presumptive diagnosis of Basidiobolus spp. infection was made and treated with amphotericin B (Itraconazol contra-indicated because of renal insufficiency). A few days later the patient died of a septic shock. After autopsy Basidiobolus ranarum was cultured from liver, gallbladder and colon.ConclusionOur patient died of gastrointestinal basidiobolomycosis with an obstructing colon tumour and a large hepatic mass. This was a rare presentation of basidiobolomycosis and the second fatal case described worldwide.

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“…Optimal treatment of GIB combines surgical and medical methods. Patients should undergo resection of all affected bowel segments and debridement of involved tissue that is followed by prolonged treatment with Azoles antifungal for up to two years is usually needed [6,10,17]. The best choice of antifungal agent is not clear, but Itraconazoleseams to be reasonable [16].…”

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confidence: 99%

Gastrointestinalbasidiobolomycosis.

AlQurashi¹,

AlMulhim²,

AlMansour³

et al. 2016

IJAR

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Basidiobolomycosisis a rare infection caused by the fungus Basidiobolusranarum, which is a known cause of subcutaneous zygomycosisbut rarely gastrointestinal manifestations have been described; the latest review reported 44 patients most were from the United States (19 patients [43%], of whom 17 [89%] were from Arizona) or Saudi Arabia (11 [25%]). Gastrointestinal basidiobolomycosis poses diagnostic difficulties; its clinical presentation is nonspecific, there are no identifiable risk factors, and all age groups are susceptible. This report presents yet another case of this disease in a Saudi male involving the gastrointestinal tract, he received hemicolectomy followed by oral Voriconazole, with successful outcome.

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Invasive Gastrointestinal Basidiobolus Ranarum Infection in an Immunocompetent Child

Cited by 19 publications

References 10 publications

Gastrointestinal basidiobolomycosis: An emerging mycosis difficult to diagnose but curable. Case report and review of the literature

Gastrointestinal basidiobolomycosis: An emerging mycosis difficult to diagnose but curable. Case report and review of the literature

A fatal pseudo-tumour: disseminated basidiobolomycosis

Gastrointestinalbasidiobolomycosis.

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