Diagnosis Of Gastrointestinal Basidiobolomycosis Research Articles

Pediatric Gastrointestinal Basidiobolomycosis: A Retrospective Study from Jazan Province, Saudi Arabia.

Basidiobolomycosis is a rare fungal infection caused by Basidiobolus ranarum, and its incidence is poorly understood due to its rarity. Gastrointestinal Basidiobolomycosis (GIB) is an uncommon presentation with limited reports in Saudi Arabia. This retrospective study aims to describe risk factors, clinical findings, diagnosis, and management of GIB in the pediatric population. We conducted a retrospective analysis of all pediatric patients diagnosed with GIB at a tertiary hospital between 2010 and 2022. Patients were identified based on their diagnosis of GIB. A self-administered questionnaire was distributed to assess risk factors associated with GIB. We analyzed 25 cases of pediatric GIB, with approximately half of the cases (56%) occurring during the COVID-19 pandemic. The mean age of affected patients was 6.6 years, with a male predominance (60%, n=15). About 100% of parents acknowledged gecko existence in their residence, and their children were exposed to insect bites. Poor appetite was reported in all patients, and high counts of eosinophils and erythrocyte sedimentation rate were observed. Thrombocytosis was present in approximately 90% of patients, and 87% had anemia. Abdominal computerized tomography scans and ultrasound-guided biopsies were the most used diagnostic tools, with cases being diagnosed based on histopathological findings and confirmed via fungal culture. Our study provides valuable information on the potential risk factors, clinical features, diagnosis, and management of pediatric GIB in the Jazan region. The observed increase in cases during the COVID-19 pandemic highlights the need for continued surveillance and research to understand better the epidemiology and associated risk factors with this rare fungal infection. These findings emphasize the need for heightened awareness, early detection, and effective prevention strategies to mitigate the impact of pediatric GIB.

Gastrointestinal Basidiobolomycosis in pediatric patients: A diagnostic dilemma and management challenge.

IntroductionBasidiobolomycosis is a rare fungal disease, lately appearing in the gastrointestinal system of pediatric patients. Their clinical presentation resembles that of lymphoma or granulomatous inflammations. This non-specific presentation makes Gastrointestinal Basidiobolomycosis (GIB) a diagnostic challenge.MethodsWe are reporting the largest series of pediatric GIB, from Saudi Arabia. 12 patients were diagnosed between January 2012 and December 2019, between the ages of 16 months and 8 years.ResultsThe most common symptoms were fever and abdominal pain. Further examination revealed an abdominal mass. Biopsy of the mass was the mainstay of diagnosis, with histological findings of typical filamentous fungal hyphae and zygospores, surrounded by eosinophils.ConclusionRole of surgery was limited to establishing the diagnosis and dealing with complications. Antifungal medication was the cornerstone of treatment in all our patients. Three of our patients were exceptional with complications such as entero-cutaneal fistula, entero-enteric fistula and short bowel syndrome. These complications have not been previously reported. We have discussed the challenges related to their management.The diagnosis of GIB in pediatric patients with abdominal mass, needs a high index of suspicion. We believe outcome depends on the severity of disease, involvement of surrounding tissues and presence of complications at the time of diagnosis.

Pediatric gastrointestinal basidiobolomycosis

Abstract Basidiobolomycosis is a rare fungal disease caused by Basidiobolus ranarum , which is an environmental saprophyte. It is a chronic inflammatory disease that is generally restricted to the subcutaneous tissue and rarely involves the gastrointestinal tract. With the intent to spread awareness of this potentially life threatening and rare infection, we report a 4-year-old boy presenting with abdominal pain and fever with eventual diagnosis of gastrointestinal basidiobolomycosis. We discuss the nonspecific and confusing symptoms of this rare infection and available treatment options in detail.

BASIDIOBOLOMYCOSIS: AN EMERGING FUNGAL INFECTION OF THE GASTROINTESTINAL TRACT IN ADULTS

Basidiobolomycosis is an unusual fungal infection known for dermatological manifestations that affect immunocompetent young adult and rarely involves the gastrointestinal tract, during the past decade many cases have been reported in Saudi Arabia with diagnosis of gastrointestinal basidiobolomycosis, most of the reported cases were in children and majority came from southern region of Saudi Arabia and all were misdiagnosed initially as either IBD or granulomatous diseases or malignancy. GIB poses diagnostic difficulties due to nonspecific presentations and rarity and has been scarcely reported in medical literatures. GIB might be a life threatening infection. So, a high index of suspicion is warranted in any child or young adult with differential diagnosis of IBD, granulomatous disease and malignancy affecting GI tract especially those patients whom are residents in or came from southern region of Saudi Arabia. In this series which is the largest reported series in adult patient with GIB in this country, we describe 4 cases of GI basidiobolomycosis from southern Region of Saudi Arabia.

Basidiobolomycosis: Case series

Basidiobolus ranarum is a fungus found in the dung of amphibians, reptiles and insectivorous bats. Basidiobolomycosis is a chronic subcutaneous infection of the trunk and limbs caused by B. ranarum. The disease is a well-known infection in the tropical areas. It usually presents with subcutaneous or gastrointestinal lesions and rarely with systemic affection. Recently, the etiologic role of B. ranarum in the gastrointestinal infections has been increasingly recognized. Here, we retrospectively reviewed the records of five patients with basidiobolomycosis, all from the same geographic region (Tohama area, Aseer province, southern region of the Kingdom of Saudi Arabia). All the cases presented with prolonged fever and other manifestations suggestive of either chronic infection (such as tuberculosis) or malignancies (such as lymphoma). The diagnosis of gastrointestinal basidiobolomycosis was established on histolological ground (granulomatous reaction, dense infiltrate of eosinophils and fungal structures). One case was diagnosed based on the histological features combined with positive tissue culture for B. ranarum. One case was treated by surgical resection of fungal masses (Case I), followed by itraconazole and amphoterecin-B therapy. The other four cases had non-resectable fungal masses and they responded very well for antifungal therapy (cases II, III, and IV received amphotericin-B and itraconazole and case V received amphotericin-B and voriconazole). Our study raises several notions. Gastrointestinal basidiobolomycosis is often misdiagnosed as cancer (lymphoma or carcinoma), tuberculosis or inflammatory bowel disease. Its recognition needs high index of suspicion and increased awareness especially in patients with chest, abdominal or neck masses and eosinophilia. The diagnosis of basidiobolomycosis can be established on histological basis in most cases. The fungal morphology and the Splendore-Hoeppli phenomenon are characteristic histological features of this condition. There are no prominent risk factors. Usually, surgery and prolonged antifungal therapy are required.

Histological and ultrastructural features of gastrointestinal basidiobolomycosis

Basidiobolus ranarum is a fungus found in the dung of amphibians, reptiles, and insectivorous bats. Its structural elements include both hyphae and zygospores. Patients with B. ranarum infection may present with subcutaneous, gastrointestinal, or systemic lesions. Here we report a case of gastrointesinal badidiomycosis in a 13-year-old male child who presented with acute abdomen. Exploration revealed a mass in the ascending colon. On histology, transmural granulomatous inflammation composed of abundant eosinophils, lymphocytes, histiocytes and giant cells was seen. Histochemical stains revealed broad, non-septate, hyphae-like structures surrounded by an eosinophilic sheath. On an ultrastructural level, fungal hyphae, spores, and macrophage-laden crystalloids were observed. The diagnosis of gastrointestinal basidiobolomycosis was established and the patient received antifungal treatment. This paper reviews the relevant literature regarding basidiomycosis, and discusses its diverse clinicopathological features, as well as distinguishing it from other diseases.