Gastrointestinal Basidiobolomycosis: An Emerging, and A Confusing, Disease in Children (A Multicenter Experience)
24 October 2016
12 December 2016
06 February 2017 (eFirst)
Introduction Gastrointestinal basidiobolomycosis (GIB) is an emerging fungal infection in children that leads to diagnostic confusion.
Aim Our study aim was twofold: a systematic review of published literature and an update of some Saudi Arabia hospital series to analyze their as well as our own experience in diagnosis and management of GIB.
Material and Methods This clinical study included 18 children whose final diagnosis was GIB. The patients, who ranged in age from 5 to 10 years, were admitted between November 2009 and November 2015 with vague abdominal pains with or without abdominal masses for further investigation.
Results Abdominal pain was the most common presenting symptom (94.4%) followed by constipation and abdominal mass (83.3 and 77.8%, respectively); fever was present in only 22.2% of the cases. Elevated inflammatory markers and eosinophilia (94.4%) appeared as prominent laboratory findings.
Conclusion We conclude that diagnosing GIB in children requires a high index of suspicion, awareness, and consideration of its possibility in the differential diagnosis in patients with abdominal masses and eosinophilia, particularly in areas where it is endemic. Increased awareness of this clinical entity, early surgical resection of the infected tissue, and prolonged treatment with itraconazole offer the best chance for curing the disease.
- 1 El-Shabrawi MH, Kamal NM. Gastrointestinal basidiobolomycosis in children: an overlooked emerging infection?. J Med Microbiol 2011; 60 (Pt 7): 871-880
- 2 Mandhan P, Hassan KO, Samaan SM, Ali MJ. Visceral basidiobolomycosis: an overlooked infection in immunocompetent children. Afr J Paediatr Surg 2015; 12 (03) 193-196
- 3 Nemenqani D, Yaqoob N, Khoja H, Al Saif O, Amra NK, Amr SS. Gastrointestinal basidiobolomycosis: an unusual fungal infection mimicking colon cancer. Arch Pathol Lab Med 2009; 133 (12) 1938-1942
- 4 Al Jarie A, Al-Mohsen I, Al Jumaah S. , et al. Pediatric gastrointestinal basidiobolomycosis. Pediatr Infect Dis J 2003; 22 (11) 1007-1014
- 5 Clark BM. The epidemiology of entomophthoromycosis. In: Al-Doory Y. , ed. The Epidemiology of Human Mycotic Diseases. Springfield, IL: Charles C. Thomas; 1975: 178-196
- 6 Lyon GM, Smilack JD, Komatsu KK. , et al. Gastrointestinal basidiobolomycosis in Arizona: clinical and epidemiological characteristics and review of the literature. Clin Infect Dis 2001; 32 (10) 1448-1455
- 7 Khan ZU, Khoursheed M, Makar R. , et al. Basidiobolus ranarum as an etiologic agent of gastrointestinal zygomycosis. J Clin Microbiol 2001; 39 (06) 2360-2363
- 8 Fahimzad A, Karimi A, Tabatabaei SR, Zadeh MG. Gastrointestinal basidiobolomycosis as a rare etiology of bowel obstruction. Turk J Med Sci 2006; 36: 239-241
- 9 Dromer F, McGinnis MR. Zygomycosis. In: Anaissie EJ, McGinnis MR, Pfaller MA. , eds. Clinical Mycology. New York, NY: Churchill Livingstone; 2002: 297-308
- 10 Albaradi BA, Babiker AM, Al-Qahtani HS. Successful treatment of gastrointestinal basidiobolomycosis with voriconazole without surgical intervention. J Trop Pediatr 2014; 60 (06) 476-479
- 11 Al-Naemi AQ, Khan LA, Khadija A. , et al. A case report of gastrointestinal basidiobolomycosis treated with voriconazole. Medicine (Baltimore) 2015; 94 (35) e1430
- 12 El-Shabrawi MH, Kamal NM, Kaerger K, Voigt K. Diagnosis of gastrointestinal basidiobolomycosis: a mini-review. Mycoses 2014; ;(57, Suppl 3): 138-143
- 13 Vikram HR, Smilack JD, Leighton JA, Crowell MD, De Petris G. Emergence of gastrointestinal basidiobolomycosis in the United States, with a review of worldwide cases. Clin Infect Dis 2012; 54 (12) 1685-1691
- 14 Rose SR, Lindsley MD, Hurst SF, Paddock CD, Damodaran T, Bennett J. Gastrointestinal basidiobolomycosis treated with posaconazole. Med Mycol Case Rep 2012; 2: 11-14
- 15 Yousef OM, Smilack JD, Kerr DM, Ramsey R, Rosati L, Colby TV. Gastrointestinal basidiobolomycosis. Morphologic findings in a cluster of six cases. Am J Clin Pathol 1999; 112 (05) 610-616
- 16 Geramizadeh B, Foroughi R, Keshtkar-Jahromi M, Malek-Hosseini SA, Alborzi A. Gastrointestinal basidiobolomycosis, an emerging infection in the immunocompetent host: a report of 14 patients. J Med Microbiol 2012; 61 (Pt 12): 1770-1774
- 17 Geramizadeh B, Heidari M, Shekarkhar G. Gastrointestinal basidiobolomycosis, a rare and under-diagnosed fungal infection in immunocompetent hosts: a review article. Iran J Med Sci 2015; 40 (02) 90-97
- 18 Al-Shanafey S, AlRobean F, Bin Hussain I. Surgical management of gastrointestinal basidiobolomycosis in pediatric patients. J Pediatr Surg 2012; 47 (05) 949-951
- 19 Al Jarie A, Al Azraki T, Al Mohsen I. , et al. Basidiobolomycosis: case series. J Mycol Med 2011; 21 (01) 37-45