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Basidiobolomycosis: Case series.

A Al Jarie1, T Al Azraki2, I Al Mohsen3

  • 1Department of Pediatrics, Aseer Central Hospital, P.O. Box 34, Abha, Saudi Arabia.

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|January 24, 2014
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Basidiobolomycosis, a chronic infection caused by Basidiobolus ranarum, is often misdiagnosed. Early recognition through high suspicion and histological diagnosis is crucial for effective treatment with antifungal therapy and surgery.

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Basidiobolus ranarum is a fungus commonly found in animal dung.
  • Basidiobolomycosis is a chronic infection, typically affecting subcutaneous tissues or the gastrointestinal tract.
  • Gastrointestinal basidiobolomycosis is increasingly recognized, often presenting with non-specific symptoms.

Purpose of the Study:

  • To retrospectively review cases of basidiobolomycosis in a specific region.
  • To highlight diagnostic challenges and treatment outcomes for gastrointestinal basidiobolomycosis.

Main Methods:

  • Retrospective review of five patient records from the Tohama area, Aseer province.
  • Diagnosis based on histological examination (granulomatous reaction, eosinophils, fungal structures) and tissue culture.

Main Results:

  • Cases presented with prolonged fever, mimicking tuberculosis or lymphoma.
  • Histological diagnosis confirmed gastrointestinal basidiobolomycosis in most patients.
  • Treatment involved surgical resection and/or prolonged antifungal therapy (itraconazole, amphotericin-B, voriconazole) with good response.

Conclusions:

  • Gastrointestinal basidiobolomycosis is frequently misdiagnosed as cancer, tuberculosis, or inflammatory bowel disease.
  • High index of suspicion and awareness are essential for early diagnosis, especially with masses and eosinophilia.
  • Histological features, including the Splendore-Hoeppli phenomenon, aid diagnosis; prolonged treatment is typically required.