Invasive retroperitoneal infection due to<i>Basidiobolus ranarum</i>with response to potassium iodide—case report and review of the literature

Nazir, Zafar; Hasan, Rumina; Pervaiz, Sadaf; Alam, Mahboob; Moazam, Farhat

doi:10.1080/02724936.1997.11747880

Cited by 29 publications

(41 citation statements)

References 7 publications

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“…) to one patient with retroperitoneal basidiobolomycosis resulted in dramatic improvement (Nazir et al, 1997). Within 6 weeks of therapy, the thoraco-lumbar mass and the suprarenal lesion resolved completely.…”

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confidence: 92%

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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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confidence: 92%

“…The best choice of antifungal agent is not clear, but itraconazole seems to show higher efficacy (Drouhet & Dupont, 1983;Lyon et al, 2001). Although clinical failure has been described with amphotericin B, KI has been used successfully for treatment of subcutaneous basidiobolomycosis (Nazir et al, 1997).…”

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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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“…Both types of entomophthoromycosis are seen most commonly in Africa and to a lesser extent in India (16,31,62,78,96). Infection due to Basidiobolus spp.…”

Section: Entomophthoromycosismentioning

confidence: 99%

Unusual Fungal and Pseudofungal Infections of Humans

Pfaller

Diekema²

2005

J Clin Microbiol

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“…In addition to being isolated from insects and reptiles, Basidiobolus has been isolated from several mammalian species. It has been found in bats (Zahari et al, 1990), horses (Miller & Pott, 1980;Vismer et al, 1980), dogs (Miller & Turnwald, 1984) and humans (Nazir et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal basidiobolomycosis in children: an overlooked emerging infection?

El-Shabrawi

Kamal

2011

Journal of Medical Microbiology

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Invasive retroperitoneal infection due toBasidiobolus ranarumwith response to potassium iodide—case report and review of the literature

Cited by 29 publications

References 7 publications

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

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

Unusual Fungal and Pseudofungal Infections of Humans

Gastrointestinal basidiobolomycosis in children: an overlooked emerging infection?

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