Basidiobolomycosis Mimicking Fistulizing Crohn's Disease: A Case Report From Saudi Arabia

Abstract

Gastrointestinal basidiobolomycosis (GIB) is a rare, emerging fungal infection caused by Basidiobolus ranarum, which requires a high index of clinical suspicion for early diagnosis and management. It is prevalent in hot and humid regions, and its clinical manifestations may mimic inflammatory bowel disease (IBD), malignancy, and tuberculosis (TB). This often results in the disease being missed or incorrectly diagnosed. We present the case of a 58-year-old female patient from the southern region of Saudi Arabia who presented with persistent non-bloody diarrhea for four weeks and was found to have GIB. This condition is associated with significant morbidity and mortality if not diagnosed and treated in a timely manner. The optimal therapeutic strategy for managing this rare infection has not yet been established. Most patients described in the literature have received a combination of pharmaceutical and surgical therapy. Including GIB in the differential diagnosis of gastrointestinal disorders that do not fit the diagnosis may help with its early diagnosis and management.

Keywords: crohn’s disease; diagnosis; fungal infection; gib; management.

Figure 1. CT scan of the abdomen - (A) axial view showing circumferential mural wall thickening (white arrow). (B) Sagittal view showing circumferential mural wall thickening of the colon (green arrow)

Figure 2. CT of the abdomen showing an entero-colonic fistula

CT: computed tomography

Figure 3. Colonoscopy showing multiple fungating masses spread throughout the colon

Figure 4. Histopathology (the arrow shows fungal spore)

Figure 5. CT of the abdomen and pelvis showing perforated colon

CT: computed tomography