Gastrointestinal basidiobolomycosis: An emerging mycosis difficult to diagnose but curable. Case report and review of the literature

• Published in: Travel medicine and infectious disease Vol. 31; p. 101378
• Main Authors: Pezzani, Maria Diletta, Di Cristo, Valentina, Parravicini, Carlo, Sonzogni, Angelica, Tonello, Cristina, Franzetti, Marco, Sollima, Salvatore, Corbellino, Mario, Galli, Massimo, Milazzo, Laura, Antinori, Spinello
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.09.2019; Elsevier Limited
• Subjects: Abdomen; Adult; Antifungal agents; Antifungal Agents - therapeutic use; Basidiobolomycosis; Biology; Blood; Cancer; Case reports; Colorectal cancer; Constipation; Emerging mycosis; Family medical history; Fever; Fungal infections; Fungi; Fungicides; Gallbladder; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - drug therapy; Gastrointestinal Diseases - microbiology; Gastrointestinal infection; Gender; Histopathology; Humans; Infectious Disease; Infectious diseases; Ireland; Italy; Itraconazole - therapeutic use; Laboratories; Liver; Male; Males; Medical diagnosis; Molecular biology; Pain; Patients; Reptiles & amphibians; Travel medicine; Treatment Outcome; Zygomycosis - diagnosis; Zygomycosis - drug therapy; Zygomycosis - microbiology; Ireland; Saudi Arabia; Iraq; Iran; United States > US; Italy; Basidiobolomycosis; Gastrointestinal infection; Emerging mycosis
• ISSN: 1477-8939; 1873-0442; 1873-0442
• DOI: 10.1016/j.tmaid.2019.01.013

Gastrointestinal basidiobolomycosis (GIB) is a rare mycosis affecting almost exclusively immunocompetent subjects. We describe a case of GIB caused by Basidiobolus ranarum in a 25-year-old Italian immunocompetent man resident in Ireland who presented a 2-month history of epigastric pain. Suspecting colon cancer he underwent a right hemicolectomy subsequently leading to a diagnosis of GIB by means of molecular biology. After surgery a 9-month therapy with itraconazole was employed with a good outcome. A review of medical literature regarding GIB cases published in the period 1964–2017 is presented. One-hundred and two cases of GIB were included in this analysis. The disease was observed predominantly in male gender (74.5%) and children (41.2%). Abdominal pain was the single most common complaint (86.3%) followed by fever (40.2%) and evidence of an abdominal mass (30.4%). Peripheral blood eosinophilia was detected in 85.7% of cases. Most of the patients were diagnosed in Saudi Arabia (37.2%) followed by USA (21.6%) and Iran (20.6%). Surgery plus antifungal therapy was employed in the majority of patients (77.5%). An unfavourable outcome was documented globally in 18.6% of patients. GIB seems to be an emerging intestinal mycosis among immunocompetent patients living in the Middle East and Arizona.