Pediatric gastrointestinal basidiobolomycosis: descriptive bicenteric retrospective study

Area of Science:

• Mycology
• Pediatric Infectious Diseases
• Gastroenterology

Background:

• Pediatric gastrointestinal basidiobolomycosis (GIB) is a rare fungal infection caused by Basidiobolus ranarum.
• It predominantly affects children in tropical and subtropical regions, often linked to agricultural environments.

Purpose of the Study:

• To present clinical, diagnostic, and therapeutic insights of pediatric GIB.
• To analyze a bicentric retrospective case series from Saudi Arabia.

Main Methods:

• Retrospective analysis of 42 pediatric GIB cases from two tertiary hospitals in Saudi Arabia.
• Data collected included demographics, clinical presentation, diagnosis (histopathology, culture), treatment, and outcomes.
• Diagnosis relied on clinical suspicion, epidemiology, and histopathology, with limited microbiological confirmation.

Main Results:

• The majority of cases (64%) were male and young children (76% ≤6 years), predominantly from the Jazan Province.
• The bowel was the most affected organ (90.47%), followed by the liver (29%).
• Voriconazole monotherapy showed high efficacy (83%), though 33% required surgery; relapses and persistent infections occurred, particularly with hepatic involvement. No mortality was observed.

Conclusions:

• Early recognition and prompt antifungal therapy, particularly voriconazole, are crucial for favorable pediatric GIB outcomes.
• Liver involvement presents a challenge, potentially leading to complications and relapse.
• Further research is needed to optimize diagnostic and treatment strategies for pediatric GIB.