Pediatric gastrointestinal basidiobolomycosis

Jarie, Ahmed Al; Al-Mohsen, Ibrahim; Jumaah, Suliman Al; Hazmi, Mohammed Al; Zamil, Fahad Al; Zahrani, Mohammed; Modovar, Edna Al; Dayel, Fouad Al; Arishii, Haider Al; Shehrani, Dayel; Martins, Jena; Mehaidib, Ali Al; Rossi, L; Olaiyan, Ibrahim; Quesne, Garry Le; Almazrou, Abdulrahman

doi:10.1097/01.inf.0000095166.94823.11

Cited by 50 publications

(46 citation statements)

References 22 publications

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“…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%

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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%

“…It is a known cause of subcutaneous zygomycosis (Hocquet, 1979;Gugnani, 1999;Khan et al, 2001). Its aetiological role in GI infections is increasingly recognized (Al Jarie et al, 2003). The presenting symptoms of GI Basidiobolus infection include fever, vomiting, abdominal pain and weight loss.…”

Section: Introductionmentioning

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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“…Seven of them were from the KSA; six were reported by Al Jarie et al (2003) (Table 1). The seventh, reported by Hussein et al (2007), was a 13-year-old boy with GIB presenting with sudden-onset acute abdominal pain with diffuse abdominal rigidity and tenderness.…”

Section: Clinical Laboratory Imaging and Histopathological Findingsmentioning

confidence: 99%

“…Surgery and prolonged antifungal therapy are usually required for treatment (van den Berk et al, 2006). To the best of our knowledge, only 26 cases of GIB have been reported worldwide: 14 adult cases (eight from the USA, two from Brazil, two from Kuwait, one from Nigeria and one from the Netherlands; Kian Joe et al, 1956;Greer & Friedman, 1966;Dworzack et al, 1978;Zahari et al, 1990;Khan et al, 2001;Lyon et al, 2001) and 12 paediatric cases (eight from Saudi Arabia, two from Brazil, one from Iran and one from Nigeria; Zahari et al, 1990;Khan et al, 2001;Al Jarie et al, 2003;Wasim Yusuf et al, 2003). A report on the 12th paediatric case, which is the 8th paediatric case in the kingdom of Saudi Arabia (KSA), is in press (El-Shabrawi et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal basidiobolomycosis in children: an overlooked emerging infection?

El-Shabrawi

Kamal

2011

Journal of Medical Microbiology

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“…GI basidiobolomycosis has been scarcely reported in the literatures and the total reported cases since 1964 till end 2012 were 44 cases worldwide. Recently, its etiologic role in gastrointestinal infections has been increasingly recognized in Saudi Arabia (Jarie et al, 2003;ElShabrawi et al, 2011;Hussein et al, 2007). To our knowledge 11 cases of GI basidiobolomycosis have been reported in Saudi Arabia: 10 cases in children and 1 case in young adult most of them came from southern region.…”

Section: Introductionmentioning

confidence: 99%

Basidiobolomycosis: An Emerging Fungal Infection of the Gastrointestinal Tract in Adults

Alshehri

Alshehri²,

Bawahab

et al. 2013

American Journal of Infectious Diseases

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Basidiobolomycosis is an unusual fungal infection known for dermatological manifestations that affect immunocompetent young adult and rarely involves the gastrointestinal tract, during the past decade many cases have been reported in Saudi Arabia with diagnosis of gastrointestinal basidiobolomycosis, most of the reported cases were in children and majority came from southern region of Saudi Arabia and all were misdiagnosed initially as either IBD or granulomatous diseases or malignancy. GIB poses diagnostic difficulties due to nonspecific presentations and rarity and has been scarcely reported in medical literatures. GIB might be a life threatening infection. So, a high index of suspicion is warranted in any child or young adult with differential diagnosis of IBD, granulomatous disease and malignancy affecting GI tract especially those patients whom are residents in or came from southern region of Saudi Arabia. In this series which is the largest reported series in adult patient with GIB in this country, we describe 4 cases of GI basidiobolomycosis from southern Region of Saudi Arabia.

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Pediatric gastrointestinal basidiobolomycosis

Cited by 50 publications

References 22 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

Gastrointestinal basidiobolomycosis in children: an overlooked emerging infection?

Basidiobolomycosis: An Emerging Fungal Infection of the Gastrointestinal Tract in Adults

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