2005
DOI: 10.1590/s0037-86822005000400014
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Case report of subcutaneous entomophthoromycosis with retroperitoneal invasion

Abstract: The authors describe a case of entomophthoromycosis in a previously healthy patient, who presented with an abscess in the right buttock. After surgical drainage it evolved into a retroperitoneal tumor. The patient improved clinically after resection of the mass and ketoconazole treatment. The histopathological analysis showed the Splendore-Hoeppli phenomenon, suggesting Basidiobolus ranarum infection, a zygomycosis generally restricted to the subcutaneous tissue, with rare gastrointestinal involvement.

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Cited by 12 publications
(11 citation statements)
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“…Although a definite diagnosis can be obtained with culture [14,15,18,19,[22][23][24]30,33,35,41,45,47,[49][50][51]54,59,62], it was frequently missed in previous reports because of the lack of suspicion that made tissue specimens unavailable for culture purpose. Therefore, the diagnosis of gastrointestinal infection by B. ranarum was mainly obtained on histologic examination, which typical morphologic features include granulomatous inflammation and a diffuse eosinophilic infiltrate with thin walled branched hyphae surrounded by eosinophilic material (Splendore-Höeppli phenomenon) and sometimes zygospores (spherical bodies with foamy cytoplasm) [4,6,12,16,17,20,24,[26][27][28][29][31][32][33][35][36][37][38][39][42][43][44]46,49,52,53,…”
Section: Discussionmentioning
confidence: 99%
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“…Although a definite diagnosis can be obtained with culture [14,15,18,19,[22][23][24]30,33,35,41,45,47,[49][50][51]54,59,62], it was frequently missed in previous reports because of the lack of suspicion that made tissue specimens unavailable for culture purpose. Therefore, the diagnosis of gastrointestinal infection by B. ranarum was mainly obtained on histologic examination, which typical morphologic features include granulomatous inflammation and a diffuse eosinophilic infiltrate with thin walled branched hyphae surrounded by eosinophilic material (Splendore-Höeppli phenomenon) and sometimes zygospores (spherical bodies with foamy cytoplasm) [4,6,12,16,17,20,24,[26][27][28][29][31][32][33][35][36][37][38][39][42][43][44]46,49,52,53,…”
Section: Discussionmentioning
confidence: 99%
“…decades a 15-fold increase in cases of gastrointestinal infection by B. ranarum has been reported worldwide. Although most of the cases have been described in the Middle East (Saudi Arabia, Iran, Iraq, Kuwait, Oman, Qatar) [23-26,29,31-39,41-46,48-50,52-55,57,60,62] and the southwestern of United States (Arizona and Utah)[15,[17][18][19][20]40,47,56], sporadic reports came from South America, Africa, Europe and the Indian Subcontinent[4,12,14,16,27,28,30,51,59,PR] and no clear environmental risk factors have been identified. In the case-control study performed by Lyon et al in Arizona, ranitidine use (OR 6.0) and a longer period of smoking (OR 2.1/additional 20 years of smoking) were both associated with the development of the disease…”
mentioning
confidence: 99%
“…The examiner may note hyperpigmentation and/or ulceration of the overlying skin. The mass lesions also may extend deeply into muscle and fascia with the potential for retroperitoneal invasion [51]. Beginning as a subcutaneous nodule, the lesion may expand over months to form lobular subcutaneous masses that can eventually ulcerate the overlying skin.…”
Section: Disease Manifestations and Clinical Diagnosismentioning
confidence: 99%
“…The inflammatory reaction can be suppurative or granulomatous. The histological examination sometimes shows the characteristic asteroid Splendore‐Hoeppli reaction 36 . The hyphae are thin‐walled, may be twisted or collapsed and often appear ring‐shaped or oval in cross‐sections.…”
Section: Mucocutaneous Infections Associated With Splendore‐hoeppli Pmentioning
confidence: 99%