Gastrointestinal basidiobolomycosis accompanied by liver involvement: a case report

Abstract

Introduction: Basidiobolomycosis is a rare disease that, unlike other fungal infections, affects immunocompetent individuals. It is caused by an environmental saprophyte named the fungus Basidiobolus ranarum. Basidiobolomycosis usually appears as a subcutaneous infection. GI basidiobolomycosis is an emerging disease, and the colon is the most frequent involved part of the GI tract.

Case presentation: The present study presents a middle-aged lady suffered from basidiobolomycosis with concomitant lesions in the cecum and liver involvement. This disease is extremely rare in adults and only a few cases have been reported so far.

Conclusions: GI basidiobolomycosis is a very rare disease which resembles as an infiltrative, infectious, or inflammatory process. Concomitant liver and bowel involvement is extremely rare too. It is an aggressive disease which has a high mortality rate despite treatments like surgical resection and prolonged antifungal therapy.

Keywords: Basidiobolomycosis; Fungal Infections; Granuloma.

Figure 1.. CT Scan of Abdomen

A: CT Scan of the abdomen revealed hypoattenuating lesions in the liver (Arrow) and thickening of the cecal wall (Arrow head) in Figure 1 -B.

Figure 2.. Colonoscopy Images of the Patient

A: Ulcers in the cecum, covered with exudative tissues with surrounding edema that resembles an infiltrative process (Arrow). The same findings were reported in the second (Figure 2 -B) and third colonoscopy (Figure 2 -C).

Figure 3.. Gross Pathology of the Terminal Ileum and Right Colon Shows Ulceration in the Cecum (Arrow)

Figure 4.. Necrotizing Granuloma, Eosinophilic Infiltration and Splendore-Hoeppli Phenomenon (Arrow)

Figure 5.. Post Treatment Ct Scan of the Abdomen

CT Scan of the Abdomen of the Patient Taken 2 Months After End of Treatment With no Evidence of Active Disease in the Liver (A) and in the Anastomosis Area (B)