Concurrent subcutaneous and visceral basidiobolomycosis in a renal transplant patient

Basidiobolomycosis is a chronic inflammatory disease that occurs exclusively in healthy individuals. Clinically, the infection is generally restricted to subcutaneous tissue; however, the disease has been documented to emerge in visceral organs but seldom spreads to cause disseminated infection. We describe the first culture-confirmed case of systemic Basidiobolus ranarum infection in an immunosuppressed patient. A 55-year-old female renal transplant recipient developed chronic hard nonpitting oedema of the right lower extremity and abdominal wall concurrent with the infection from the same organism involving the uterus, urinary bladder and intra-abdominal lymph nodes. The patient responded successfully, both clinically and radiographically, to medical therapy without surgical resection. The treatment regimen consisted of potassium iodide and trimethoprim/sulfamethoxazole for 3 months, and the patient remains clear of symptoms after 10 months' follow-up.