Gastrointestinal basidiobolomycosis - A rare fungal infection: Challenging to diagnose yet treatable - Case report and literature review

Gastrointestinal basidiobolomycosis masquerading as cancer

Gastrointestinal basidiobolomycosis is an unusual fungal infection caused by Basidiobolus ranarum, a saprophytic fungus primarily found in soil and decaying vegetables. Basidiobolomycosis typically presents as a chronic subcutaneous swelling and rarely infects the gastrointestinal tract. Thus, the infrequency of gastrointestinal infections, along with nonspecific clinical symptoms, often results in misdiagnosed cases and delays in treatment. In this article, we report the case of a 68-year-old male with gastrointestinal basidiobolomycosis masquerading as metastatic cancer. We focus on the use of radiological imaging modalities and histopathological analysis to optimize the diagnosis and treatment of this rare gastrointestinal infection.

Gastrointestinal Basidiobolomycosis: A Case Series

Gastrointestinal basidiobolomycosis (GIB) is a rare fungal infection caused by Basidiobolus ranarum, a saprophytic fungus that belongs to the class of Basidiobolomycetes. It mainly infects immunocompetent individuals and is mainly found in arid tropical and subtropical regions, including Southwestern America, Saudi Arabia, Africa, and Asia. Not surprisingly, a great number of human infections have been reported from these warm, humid climate regions that are felicitous for the growth of this fungus, especially from the southern region of Saudi Arabia and Arizona in the United States of America. GIB is easily misdiagnosed as malignancy, inflammatory bowel disease, diverticulitis, lymphoma, and chronic intestinal infections due to its rarity. In this case series, we summarize the clinical features, imaging, histopathological features, and treatment of patients diagnosed with GIB in our institution.

Fungal thermotolerance revisited and why climate change is unlikely to be supercharging pathogenic fungi (yet)

Thermotolerance has been viewed as an uncommon characteristic among the fungi and one of the reasons that less than 1% of the described species operate as opportunistic pathogens of humans. Growth at 37°C is certainly a requirement for a fungus that invades the body core, but tens of thousands of nonpathogenic species are also able to grow at this temperature. Ergo, body temperature does not serve as a thermal barrier to the development of infections by many harmless fungi. The absence of other virulence factors must be more demanding. This observation raises questions about the hypothetical links between climate change and the increasing number of life-threatening human mycoses. Given the widespread distribution of fungal thermotolerance and the 1°C (2°F) increase in global temperature over the last 140 years it seems unlikely that the warming climate has driven the evolution of more virulent strains of fungi. More compelling explanations for the changes in the behavior of fungi as disease agents include their adaptation to the widening use of azole antifungals in hospitals and the wholesale application of millions of tons of the same class of heterocyclic chemicals in agriculture. On the other hand, climate change is having a significant effect on the spread of human mycoses by extending the geographical range of pathogenic fungi. A related increase in fungal asthma caused by spore inhalation is another likely consequence of planetary change.