Surgical management of colonic basidiobolomycosis among adolescent and adult patients: presentation and outcome

Abstract

Colonic basidiobolomycosis is a life-threatening fungal infection that should be considered a surgical condition. A high index of suspicion including basidiobolomycosis in the differential diagnosis for the acute abdomen with a colonic mass is required for a proper diagnosis. Early aggressive surgical management followed by a prolonged course of itraconazole postoperatively could improve the outcome of the condition.

Gastrointestinal basidiobolomycosis: Beware of the great masquerade a case report

“…In a recent review of 102 cases of GIB, abdominal pain (86.3%) was the most common presenting symptom followed by weight loss (33.3%), abdominal distension (16.7%), vomiting (15.7%) and diarrhea (13.7%) with fever reported in 40.2% of patients and an abdominal mass was palpable in 30.4% of cases [10]. GIB most commonly involves the right colon [11] and frequently presents as abdominal mass mimicking colonic malignancy and inflammatory bowel disease [6]. Common laboratory findings in patients with GIB are neutrophilic leucocytosis, eosinophilia and a high ESR [8].…”

Colonic basidiobolomycosis presenting with intestinal obstruction and a normal eosinophil count

“…GIB poses diagnostic difficulties as its clinical presentation is non-specific. Abdominal pain, anorexia, and loss of weight were found in all patients with colonic basidiobolomycosis, and less common symptoms include diarrhea (9.0%) and lower gastrointestinal bleeding (13.6%) [4]. Our case presentation was suspicious for metastatic colon cancer in view of the patient’s age and the presence of the colonic mass.…”

“…The colon is the most commonly involved organ (82%), followed by the small bowel (36%). On the other hand, liver and biliary disease are reported in less than 30% of GIB cases [3,4].…”

Gastrointestinal Basidiobolomycosis: A Case Series

“…The main differential diagnoses include inflammatory bowel diseases (IBD) such as Crohn's disease (CD), intestinal tuberculosis, and other granulomatous diseases [ 10 , 11 ]. Additionally, GIB should be considered in the differential diagnosis of mucormycosis, particularly in cases of colonic masses and eosinophilic intestinal inflammation [ 12 , 13 ]. The condition may also mimic malignancies; furthermore, the presence of eosinophilic granulomatous tissue reaction prompts consideration of entomophthoromycosis and other fungal infections [ 1 , 13 , 14 ].…”

“…Treatment options for GIB in adults typically involve a combination of surgical intervention and antifungal therapy. Surgery, often in the form of resection, has been a mainstay in the management of GIB, with the majority of patients having antifungal therapy in conjunction [ 1 , 5 , 12 ]. This approach aims to achieve complete removal of the infected tissue and reduce the fungal burden within the gastrointestinal tract.…”