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Case Reports
. 2020 Nov 11:37:227.
doi: 10.11604/pamj.2020.37.227.20994. eCollection 2020.

Disseminated and ulcerative basidiobolomycosis simulating a Buruli ulcer in an immunocompetent girl in Southern Benin

Akimath Habib  1 , Christelle D Almeida  2 , Bérénice Degboe  3   4 , Benjamin Morvant  5 , Marlène Lyne Ganlonon  1 , Ambroise Adeye  1 , Anne Croue  5 , Maxime Kiki  1 , Espoir Sodjinou  1
Affiliations
Case Reports

Disseminated and ulcerative basidiobolomycosis simulating a Buruli ulcer in an immunocompetent girl in Southern Benin

Akimath Habib et al. Pan Afr Med J. .

Abstract

Basidiobolomycosis is a subcutaneous mycosis, for which non-specific clinical presentation can be a source of diagnostic wandering. A 5-year-old girl was brought for consultation with chronic ulcers of the pelvic limbs evolving for 8 months. The lesions started when the girl was 18 months old with a painless, pruritic nodule of the right buttock, indurated placard following progressive extension to the pelvic limbs, back and abdomen, and secondarily ulcerated in several places. On examination, there was an alteration of the general condition, a large, indurated and erythematous plaque, with sharp edges. On this plaque, there were nodular lesions and necrotic ulcers, with detached margins. The left knee was blocked in flexion. Ziehl staining and polymerase chain reaction for Mycobacterium ulcerans were negative. The histopathological picture was suggestive of basidiobolomycosis. The evolution was favorable after giving her ketoconazole (100mg per day) for 14 weeks associated with surgery and physiotherapy. This clinical case confirms the difficulties in diagnosing basidiobolomycosis, especially in endemic areas of Buruli ulcer.

Keywords: Basidiobolomycosis; Buruli ulcer; co-endemicity; histopathology; mycosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
A) erythematous and indurated plaque of lower limbs extending to the abdomen with necrotic ulcer on the right buttock; B) necrotic ulcers on right buttock and posterior side of the left pelvic limb; C) indurated plaque with necrotic ulcer on the inner side of the left thigh associated lymphoedema
Figure 2
Figure 2
A) hematoxylin-eosin-safran staining showing Splendore-Hoeppli phenomenon (yellow open arrow): perivascular granulomas centered by extracellular eosinophilic (X100); B) grocott staining showing granulomas centered by extracellular eosinophilic masses (blue open arrow) and bulky mycelial filaments (yellow open arrow) (X100)
Figure 3
Figure 3
A) ulcers of buttock and posterior face of left lower limb healing after mesh grafting and knee flexion correction; B) ulcers of anterior face of left lower limb healing after mesh grafting
See this image and copyright information in PMC

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