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Al Yazidi L, Al Sinani S, Al Adawi B, Al Riyami M, Wali Y, Al Rawas A, Al Musalhi B, Meis JF, Al Housni S, Al-Harrasi A, Al Hatmi AMS. Disseminated Basidiobolomycosis Caused by Basidiobolus omanensis in a Child with Acute Lymphoblastic Leukemia (ALL). Case Report and Literature Review. Mycopathologia 2024; 189:12. [PMID: 38231359 PMCID: PMC10794288 DOI: 10.1007/s11046-023-00820-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/26/2023] [Indexed: 01/18/2024]
Abstract
Basidiobolomycosis is an uncommon fungal infection caused by the genus Basidiobolus. In immunocompetent children, it usually causes cutaneous infection and rarely affects the gastrointestinal tract, and it is extremely rare for the disease to spread. The present study reports the first case of disseminated basidiobolomycosis caused by Basidiobolus omanensis in a child with acute lymphoblastic leukemia who died as a result of uncontrolled infection and multi-organ failure despite surgical and antifungal therapy with L-AMB and voriconazole. A review of the literature yielded 76 cases, including the current case with the majority of which were reported as invasive gastrointestinal infection. The median age was 4 years (61 male and 15 female) and the majority of these children were from the Middle East (80%), specifically Saudi Arabia (45%). Most patients were treated with systemic antifungal agents (mostly itraconazole and amphotericin B). Surgical intervention was done in 25% of these patients and the death rate was 12%.
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Affiliation(s)
| | | | - Badriya Al Adawi
- Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Marwa Al Riyami
- Department of Pathology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Yasser Wali
- Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Buthaina Al Musalhi
- Department of Family Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Jacques F Meis
- Center of Expertise in Mycology, Radboud University Medical Center, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Saif Al Housni
- Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
| | - Abdullah M S Al Hatmi
- Center of Expertise in Mycology, Radboud University Medical Center, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
- Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman.
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Habib A, D Almeida C, Degboe B, Morvant B, Ganlonon ML, Adeye A, Croue A, Kiki M, Sodjinou E. Disseminated and ulcerative basidiobolomycosis simulating a Buruli ulcer in an immunocompetent girl in Southern Benin. Pan Afr Med J 2020; 37:227. [PMID: 33520066 PMCID: PMC7821815 DOI: 10.11604/pamj.2020.37.227.20994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 10/29/2020] [Indexed: 11/20/2022] Open
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.
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Affiliation(s)
- Akimath Habib
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Cotonou, Bénin
| | - Christelle D Almeida
- Service de Dermatologie-Vénérologie, Hôpital d´Instruction des Armées de Cotonou, Cotonou, Bénin
| | - Bérénice Degboe
- Faculté des Sciences de la Santé, Université d´Abomey-Calavi, Cotonou, Bénin.,Service de Dermatologie-Vénérologie, Centre National Hospitalier et Universitaire Hubert Koutoukou Maga, Cotonou, Bénin
| | - Benjamin Morvant
- Département de Pathologie Cellulaire et Tissulaire, Unité de Formation d'Anatomie Cytologie Pathologique, Centre Hospitalier et Universitaire d´Angers, Angers, France
| | - Marlène Lyne Ganlonon
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Cotonou, Bénin
| | - Ambroise Adeye
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Cotonou, Bénin
| | - Anne Croue
- Département de Pathologie Cellulaire et Tissulaire, Unité de Formation d'Anatomie Cytologie Pathologique, Centre Hospitalier et Universitaire d´Angers, Angers, France
| | - Maxime Kiki
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Cotonou, Bénin
| | - Espoir Sodjinou
- Centre de Dépistage et de Traitement de la Lèpre et de l´Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Cotonou, Bénin
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Hung TY, Taylor B, Lim A, Baird R, Francis JR, Lynar S. Skin and soft tissue infection caused by Basidiobolus spp. in Australia. IDCases 2020; 20:e00731. [PMID: 32215254 PMCID: PMC7090362 DOI: 10.1016/j.idcr.2020.e00731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 02/23/2020] [Accepted: 02/23/2020] [Indexed: 11/30/2022] Open
Abstract
Fungi from the order Entomophthorales are rare but well recognized cause of tropical fungal infection, typically causing subcutaneous truncal or limb lesions in immunocompetent hosts. They may also mimic malignancy by causing intrabdominal mass, sometimes resulting in obstructive gastrointestinal or renal presentations. A 4-year-old female presented with a progressively growing abdominal wall lesion over several months, developing into acute inflammation of the abdominal wall with systemic symptoms. She underwent surgical debridement and fungal culture of subcutaneous tissue was positive for Basidiobolus spp with characteristic histopathological findings. Treatment with voriconazole followed by itraconazole over a total duration of 6 weeks led to complete resolution. Basidiobolus spp is an unusual cause of infection with characteristic mycological and histopathological findings. Infection can present in a number of ways ranging from a slow-growing mass in the subcutaneous soft tissue to an invasive mass in the gastrointestinal tract. Identification of its unique beak-like zygospore and Splendore-Hoeppli phenomenon on histopathological specimens can be pathognomonic and could provide the key to early diagnosis. Review of the literature found that timely diagnosis and commencement of antifungal therapy can be curative with or without surgical treatment. Considering the rarity of this tropical infection, this case provides the opportunity for revision of the typical presentations and diagnostic findings of Basidiobolus spp. With early recognition and suitable treatment, outcomes are generally favorable.
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Affiliation(s)
- Te-Yu Hung
- Department of Microbiology, Territory Pathology, Royal Darwin Hospital, 105 Rocklands Drive Tiwi, Northern Territory, 0810, Australia.,Department of Paediatrics, Royal Darwin Hospital, Northern Territory, 0810, Australia
| | - Brooke Taylor
- Department of Microbiology, Territory Pathology, Royal Darwin Hospital, 105 Rocklands Drive Tiwi, Northern Territory, 0810, Australia
| | - Aijye Lim
- Department of Anatomical Pathology, Territory Pathology, Royal Darwin Hospital, Tiwi, Northern Territory, 0810, Australia
| | - Robert Baird
- Department of Microbiology, Territory Pathology, Royal Darwin Hospital, 105 Rocklands Drive Tiwi, Northern Territory, 0810, Australia
| | - Joshua R Francis
- Department of Paediatrics, Royal Darwin Hospital, Northern Territory, 0810, Australia.,Menzies School of Health Research, Charles Darwin University, Northern Territory, 0810, Australia
| | - Sarah Lynar
- Department of Infectious Diseases, Royal Darwin Hospital, Northern Territory, 0810, Australia.,Menzies School of Health Research, Charles Darwin University, Northern Territory, 0810, Australia
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Darré T, Saka B, Mouhari-Toure A, Djiwa T, Pitché P, Napo-Koura G. Basidiobolomycosis in Togo: clinico-pathological study of a series of 12 presumed cases. BMC Res Notes 2018; 11:667. [PMID: 30217237 PMCID: PMC6137730 DOI: 10.1186/s13104-018-3777-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 09/10/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The purpose of our study was to describe the histological diagnosed of the Basidiobolomycosis cases from 1990 to 2017 (28 years) in the only Pathology Anatomy Laboratory in Togo. RESULTS A total of 12 cases of suspected Basidiobolomycosis have been identified. The sex ratio (M/F) was 2. The average age of the patients was 24.8 ± 1.6 years. Six patients (6/12) had a pathological history: HIV infection (n = 4 cases) and tuberculosis (n = 2 cases). The clinical manifestations were localized to pure skin (n = 9 cases), skin and mucous digestive (n = 2 cases) and disseminated (n = 1 cases). Direct mycological examination and culture in 4 patients was positive in 3 patients. The samples examined consisted of 11 cutaneous biopsies measuring 1-3 cm and a biopsy of the intestinal mucosa. Histology showed granulomatous inflammation of the dermohypodermal site with numerous giant cells associated with eosinophilic polynuclear cells, in which there are 5-7 mm non-septate, irregular mycelial filaments. Patients were treated with ketoconazole at a dose of 10 mg/kg daily. The progression of the patients' condition was favorable after 4 weeks of treatment with a regression of the closets size. Patients were completely healed after 8 weeks of treatment, without recurrence after 6 months. No deaths have been recorded.
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Affiliation(s)
- Tchin Darré
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo. .,University of Lomé, BP 1515, Lomé, Togo.
| | - Bayaki Saka
- Department of Dermatology, University Teaching Hospital of Lomé, Lomé, Togo
| | - Abas Mouhari-Toure
- Department of Dermatology, University Teaching Hospital of Kara, Kara, Togo
| | - Toukilnan Djiwa
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo
| | - Palokinam Pitché
- Department of Dermatology, University Teaching Hospital of Lomé, Lomé, Togo
| | - Gado Napo-Koura
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo
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