Gastrointestinal Basidiobolomycosis: First case report from Oman and literature review

Abstract

Gastrointestinal basidiobolomycosis (GIB) is a rare fungal infection with few reported cases worldwide. We report here the first case diagnosed in Oman in a previously healthy 5-year-old Omani female child who had been thought initially to have an abdominal malignancy. The case was referred to the Royal Hospital, Muscat, Oman, in July 2012. She was treated successfully with surgical resection and prolonged antifungal therapy (voriconazole). Physicians, including clinicians, radiologists and pathologists, should have a high index of suspicion for GIB when a patient presents with an abdominal mass and fever.

Keywords: Case Report; Child; Entomophthorales; Gastrointestinal Diseases; Mycoses; Oman; Zygomycosis.

Figure 1:

A large mass of heterogeneous density (arrow) in the right iliac fossa inseparable from the bowel loops with a markedly thickened irregular bowel wall involving the caecum, ascending colon and, to a lesser extent, the terminal ilium.

Figure 2:

Fungal hyphae surrounded by the Splendore-Hoeppli phenomenon (white arrow) and dense eosinophil infiltrates (black arrows) at × 40 magnification with haematoxylin and eosin stain.

Figure 3

A & B: Microscopic morphology of Basidiobolus spp showing globose one-celled conidia that are forcibly discharged from a sporophore (arrow) at × 100 magnification with lactophenol blue stain (A). Microscopic morphology of Basidiobolus spp showing numerous round smooth thick-walled zygospores (arrow) at × 100 magnification (B).