P188 An uncommon case of subcutaneous basidiobolomycosis in a young adult — a case report

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMBasidiobolomycosis is an uncommon fungal infection of the subcutaneous tissue of the lower limbs caused by Babsidiobolus ranarum. It presents as chronic granulomatous inflammation of the skin and subcutaneous tissues affecting the immunocompetent young adults. We report a 23-year-old male who presented with soft tissue swelling of the left lower limb for the past 4 months. He had consulted a private hospital previously where he underwent incision and drainage and was prescribed multiple antibiotics. As there was no resolution of the symptoms, he presented to us with swelling of the thigh and 1 × 1 cm size non-healing ulcer over the posterolateral aspect at the site of incision with inflammation of the surrounding tissues. On examination, the surrounding tissues also showed induration and warmth. The routine blood investigations were normal and serology for HIV was also negative. The pus aspirate was cultured in Saborauds's Dextrose agar and incubated at 25°C showed growth of creamy, glabrous, heaped up, radially furrowed colonies after 4 days. On microscopic examination with lactophenol cotton blue preparation broad, aseptate hyphae with numerous thick-walled beaked zygospores were observed as characteristic of B. ranarum. Based on the culture results diagnosis of basidiobolomycosis was made and the patient was started on oral itraconazole. There was a marked reduction in the size of swelling and healing of the ulcer following 10 weeks of oral itraconazole therapy. This report highlights the need for awareness of this disease for the correct diagnosis of this disfiguring condition which is treatable.