A New form of Abdominal Zygomycosis Different from Mucormycosis

Bittencourt, Achiléa Lisboa; Ayala, Marciano Antonio Rojas; Ramos, Eduardo Antônio Gonçalves

doi:10.4269/ajtmh.1979.28.564

Cited by 35 publications

(20 citation statements)

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“…Surprisingly, the hyphae in the infected tissues did not show the typical Splendore -Hoeppli phenomenon characteristic of the entomophthoraceous fungi, attributable in part to the immune status of the host. Although C. lampragues infection in animals was found to affect the rhinofacial and rhinopharyngeal areas, the only human case of infection by C. lampragues involved internal organs similar to systemic cases reported in C. coronatus (Walker et al 1992) and C. incongruus infection (Bittencourt et al 1979;Walsh et al 1994). …”

Section: Lampraguesmentioning

confidence: 85%

“…Interestingly, small masses, termed "kunkers" by some, are recovered only from the tissues of infected horses (Mendoza and Alfaro 1985); these soft masses have not been described in humans. Most diagnosed human cases of C. coronatus infection are in African adults; however, cases have also been reported in Asia and Latin America (Bittencourt et al 1979;Yang et al 2010;IsaIsa et al 2012). Cases of conidiobolomycosis in the United States and Australia have been diagnosed mainly in horses and dogs (Miller and Campbell 1982).…”

Section: Coronatusmentioning

confidence: 99%

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Human Fungal Pathogens of Mucorales and Entomophthorales

Mendoza

Vilela

Voelz

et al. 2014

Cold Spring Harbor Perspectives in Medicine

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In recent years, we have seen an increase in the number of immunocompromised cohorts as a result of infections and/or medical conditions, which has resulted in an increased incidence of fungal infections. Although rare, the incidence of infections caused by fungi belonging to basal fungal lineages is also continuously increasing. Basal fungal lineages diverged at an early point during the evolution of the fungal lineage, in which, in a simplified four-phylum fungal kingdom, Zygomycota and Chytridiomycota belong to the basal fungi, distinguishing them from Ascomycota and Basidiomycota. Currently there are no known human infections caused by fungi in Chytridiomycota; only Zygomycotan fungi are known to infect humans. Hence, infections caused by zygomycetes have been called zygomycosis, and the term "zygomycosis" is often used as a synonym for "mucormycosis." In the four-phylum fungal kingdom system, Zygomycota is classified mainly based on morphology, including the ability to form coenocytic (aseptated) hyphae and zygospores (sexual spores). In the Zygomycota, there are 10 known orders, two of which, the Mucorales and Entomophthorales, contain species that can infect humans, and the infection has historically been known as zygomyEditors:

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Section: Lampraguesmentioning

confidence: 85%

Section: Coronatusmentioning

confidence: 99%

Human Fungal Pathogens of Mucorales and Entomophthorales

Mendoza

Vilela

Voelz

et al. 2014

Cold Spring Harbor Perspectives in Medicine

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“…GI basidiobolomycosis is rare (Bittencourt et al, 1979;Khan et al, 1998), with only 14 cases in adults (Khan et al, 2001;Lyon et al, 2001) and 12 cases in children (Al Jarie et al, 2003;Wasim Yusuf et al, 2003) having been reported worldwide. The reported cases included eight cases from the United States; eight from the Kingdom of Saudi Arabia, four from Brazil, two each from Nigeria and Kuwait, one from Iran and one from the Netherlands (de Aguiar et al, 1980;Schmidt et al, 1986;Pasha et al, 1997;Khan et al, 1998;Smilack, 1998;Yousef et al, 1999;Zavasky et al, 1999;Al Jarie et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal basidiobolomycosis: an emerging fungal infection causing bowel perforation in a child

El-Shabrawi

Kamal

Jouini

et al. 2011

Journal of Medical Microbiology

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Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal (GI) tract. We report a 10-year-old boy diagnosed as suffering GI basidiobolomycosis after being misdiagnosed first as suffering intestinal malignancy then schistosomiasis. The patient presented with fever, abdominal pain, vomiting, abdominal tenderness and rigidity with marked blood eosinophilia. Abdominal ultrasonographic and computed tomographic scans revealed a large caecal mass. Biopsy of the mass showed transmural granulomatous inflammation interpreted as schistosomal granuloma, ruling out lymphoma. The patient's condition deteriorated despite anti-schistosomal therapy. Emergency surgery was then performed, and caecal perforation was found. The mass was excised; cultures were negative and histopathological examination was suggestive of schistosomal granuloma. The mass recurred 3 weeks post-operatively. Secondopinion histopathological examination diagnosed Basidiobolus ranarum infection. Treatment with itraconazole produced marked improvement, with diminution of the mass. B. ranarum was unequivocally identified in the archival formalin-fixed and paraffin-embedded (FFPE) tissue by PCR. This case emphasizes the need to consider GI basidiobolomycosis in children presenting with fever, abdominal mass and eosinophilia, especially those complicated by bowel perforation. IntroductionBasidiobolus species are filamentous fungi that belong to the order Entomophthorales. Unlike other fungi (e.g. Mucorales) classified to the former zygomycetes, they cause subcutaneous zygomycosis in healthy individuals (Singh et al., 2008). Basidiobolus ranarum was first described as an isolate from frogs in 1886. It was cultured from frogs' intestinal contents and excreta (Ribes et al., 2000). It is commonly found in soil and decaying vegetable matter. It is occasionally present as a commensal in the gastrointestinal (GI) tracts of amphibians, reptiles, fish and mammals such as frogs, toads, turtles, fish, chameleons, horses, dogs and bats (Kaufman et al., 1990;Zahari et al., 1990;Gugnani, 1999). The micro-organism was first isolated in 1955 from decaying plants in the United States. Subsequently it was found in soil and vegetation worldwide (Greer & Friedman, 1966). Basidiobolus is endemic in Uganda and certain other areas of Africa, and in parts of Asia including India (Ribes et al., 2000). In the past, clinical isolates of Basidiobolus were classified as B. ranarum, B. meristosporus and B. haptosporus. However, recent taxonomic studies based on antigenic analysis, isoenzyme banding and restriction enzyme analysis indicate that all human pathogens belong to B. ranarum. In two studies, B. ranarum was commonly isolated from South India (Khan et al., 2001;Sujatha et al., 2003).Zygomycosis is characterized by tissue invasion with broad, non-septate hyphae of fungal species such as Rhizopus, Rhizomucor, Absidia and Basidiobolus. Fungal elements of B. ranarum include hyphae and zygospores (Hocquet, 1979;Gugnani, 1999). The hyphae are thin-wall...

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“…It is not clear how B ranarum gains access to the gastrointestinal tract of patients, but previously reported cases of gastrointestinal basidiobolomycosis (GIB) were attributed to ingestion, with the portal of entry being the stomach, or to direct inoculation via minor rectal trauma, followed by the contiguous spread of infection [3,4]. It affects mostly males and is found mainly in tropical and subtropical areas [1,5].…”

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confidence: 99%