Colonic basidiobolomycosis presenting with intestinal obstruction and a normal eosinophil count

Area of Science:

• Mycology
• Gastroenterology
• Pathology

Background:

• Gastrointestinal basidiobolomycosis (GIB) is a rare fungal infection caused by *Basidiobolus ranarum*.
• Cases are predominantly reported from warm regions, including the USA, Saudi Arabia, and Iran.

Observation:

• A middle-aged patient presented with symptoms suggestive of metastatic colonic carcinoma, including constipation, anorexia, and weight loss.
• CT scans revealed a sigmoid colon mass and a hepatic lesion.
• Surgical specimens showed transmural inflammation, necrotizing granulomas, and fungal hyphae consistent with basidiobolomycosis.

Findings:

• Histopathological examination confirmed GIB.
• Molecular testing further validated the diagnosis.
• The patient was treated with surgical resection and voriconazole.

Implications:

• This case underscores the importance of considering GIB in the differential diagnosis of colonic masses, especially in endemic areas.
• Early diagnosis and prompt treatment, combining surgical intervention and antifungal therapy, are crucial for favorable outcomes.
• Increased physician awareness is essential for timely recognition and management of this rare condition.