Abstract
Introduction:Gastrointestinal basidiobolomycosis (GIB) is an emerging fungal infection with a few cases reported worldwide. It is caused by Basidiobolus ranarum, which does not usually invade blood vessels and rarely disseminates.Case presentation:We present a rare case of GIB with hepatic dissemination in a 12-year-old Yemeni boy living in southwestern Saudi Arabia. The initial provisional diagnosis was intestinal lymphoma, and a right hemicolectomy was carried out, but histopathological assessment ruled out lymphoma and suggested intestinal tuberculosis. Two weeks after starting antituberculous medications, the patient was referred to our hospital because of fever and right upper abdominal discomfort. There was leukocytosis with marked eosinophilia, and a liver biopsy showed evidence of B. ranarum infection. A second opinion by histopathological examination of resected tissues diagnosed colonic basidiobolomycosis. The patient was treated successfully with itraconazole.Conclusion:GIB is an emerging disease in southwestern Saudi Arabia and should be considered in a patient with an abdominal mass and eosinophilia coming from this region. Persistent elevation of leukocytes and eosinophils after surgical resection of the affected tissue could be used as a predictor of fungal dissemination. Further research is needed for a better understanding of GIB.
Highlights
Gastrointestinal basidiobolomycosis (GIB) is an emerging fungal infection with a few cases reported worldwide
Basidiobolomycosis is a rare fungal infection caused by Basidiobolus ranarum, an environmental saprophyte, which is a member of the order Entemophthorales, class Zygomycetes (De Leon-Bojorge et al, 1988; Kwon-Chung & Bennett, 1992)
Leukocytosis, marked eosinophilia and elevated erythrocyte sedimentation rate (ESR) and C-reactive protein were found in our case, as in other reports (Al-Qahtani et al, 2013; Al Saleem et al, 2013)
Summary
Basidiobolomycosis is a rare fungal infection caused by Basidiobolus ranarum, an environmental saprophyte, which is a member of the order Entemophthorales, class Zygomycetes (De Leon-Bojorge et al, 1988; Kwon-Chung & Bennett, 1992). Two weeks after the relief of symptoms, he was referred to our hospital (King Saud Medical City) because of fever and right upper abdominal discomfort. On examination, he looked unwell and emaciated, his temperature was 39.5 uC and he had tenderness in the right upper quadrant of the abdomen. He looked unwell and emaciated, his temperature was 39.5 uC and he had tenderness in the right upper quadrant of the abdomen His laboratory work-up showed the following: white blood cells (WBCs) 19 000 mm, eosinophils 23 %, haemoglobin 9 g/dl, platelets 46105 mm, ESR 120 mm/h and C-reactive protein 90 mg/dl, with normal liver and renal profiles.
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