Basidiobolomycosis Mimicking Fistulizing Crohn’s Disease: A Case Report From Saudi Arabia

Abstract

Gastrointestinal basidiobolomycosis (GIB) is a rare, emerging fungal infection caused by Basidiobolus ranarum, which requires a high index of clinical suspicion for early diagnosis and management. It is prevalent in hot and humid regions, and its clinical manifestations may mimic inflammatory bowel disease (IBD), malignancy, and tuberculosis (TB). This often results in the disease being missed or incorrectly diagnosed.We present the case of a 58-year-old female patient from the southern region of Saudi Arabia who presented with persistent non-bloody diarrhea for four weeks and was found to have GIB. This condition is associated with significant morbidity and mortality if not diagnosed and treated in a timely manner. The optimal therapeutic strategy for managing this rare infection has not yet been established. Most patients described in the literature have received a combination of pharmaceutical and surgical therapy. Including GIB in the differential diagnosis of gastrointestinal disorders that do not fit the diagnosis may help with its early diagnosis and management.

Gastrointestinal Basidiobolomycosis: A Case Series

“…Thus, the differential diagnosis for GIB in adults encompasses a range of conditions due to its nonspecific clinical presentation, leading to misdiagnosis and delay. The main differential diagnoses include inflammatory bowel diseases (IBD) such as Crohn's disease (CD), intestinal tuberculosis, and other granulomatous diseases [10,11]. Additionally, GIB should be considered in the differential diagnosis of mucormycosis, particularly in cases of colonic masses and eosinophilic intestinal inflammation [12,13].…”

“…Occasionally abscess formation in the affected area can be seen appearing as a localized collection of pus or fluid; however, these are not specific to GIB [9,17]. Colonoscopy aids in the diagnosis, but endoscopic features are typical of inflammatory processes, such as ulcerated polypoidal or nodular mucosa with necrosis and exudates [1,10,11,14]. Biopsies of the involved organ, colon, or liver often show features of nonspecific inflammation.…”