Subcutaneous entomophthoromycosis mimicking soft-tissue sarcoma in children

Human Pathogenic Entomophthorales

“…Infections caused by C. incongruus have been diagnosed in both apparently healthy and immunocompromised hosts (32,49,172,174,184). In contrast to C. coronatus, C. incongruus has been recovered in culture more often from cases of systemic infections than from cases of localized subcutaneous disease (31, 35, (42); fever, anorexia, pleuritic and chest pain, fever, severe wt loss with lung involvement, and dissemination to blood vessels and brain are the main findings (165,169,171) Unusual cases involving subcutaneous tissues in anatomical areas other than the face have been reported (45,209) There is a rare report without culture suggesting disseminating infection due to C. coronatus from the face to liver, kidney, and small intestine (210) Conidiobolus incongruus Cases in humans are rare; patients with this infection showed refractory fever, cellulitis of the forehead with sinusitis, obstruction of the nares, periorbital edema, and orbital inflammation (82,172,174,180) Systemic infections are common in immunocompromised hosts (35,47); involvement of the lungs was a common feature in these patients; anorexia, persistent cough with or without hemoptysis, fever, and wt loss; invasion of internal organs, including with intestinal infection with dissemination to liver, small bowel, gallbladder, pancreas, kidney, or retroperitoneum have been reported (142,185,186,197,227); pulmonary infection spread from a cutaneous lesion was also recorded (191) Reported to occur in apparently healthy hosts; lesions are painless and found around the neck, trunk, limbs, buttocks, and, less frequently, other sites (51,53,183); usually, edematous extensive single granulomatous lesions are observed; in the infected areas, there is moderate to severe pruritus around nodular lesions with eroded to ulcerative granulomas (184,188) Reported to occur in apparently healthy individuals; common clinical signs include abdominal pa...…”

Entomophthoramycosis: a neglected tropical mycosis

“…Surgery plays a limited role in treatment of entomophthoramycosis. While surgical resection of lesions of basidiobolomycosis may be attempted, there is a risk of recurrence at the sites of surgical excision [61]. Surgical management of nasofacial conidiobolomycosis may be useful in early disease where cosmetic injury may be minimized.…”

An unusual presentation of unilateral lower limb gigantism in a case of subcutaneous entomophthoromycosis

“…4 The sites of involvement in descending order of frequency are gluteal region, thigh, anterior abdominal wall, chest, and back, in the "bathing suit" distribution. 1,5 It presents as firm, painless erythematous plaques or disc-shaped rubbery mobile masses easily lifted from deeper tissues (doughnut lifting sign). The presentation of basidiobolomycosis as diffuse swelling of an entire limb resembling gigantism is a relatively rare one, with only a few reports in literature.…”

“…However, the sensitivity of culture for subcutaneous mycosis is low, and diagnosis can be made with microscopic identification of the fungi even in the absence of positive culture. 5 Basidiobolomycosis responds excellently to potassium iodide and oral azoles.…”