Basidiobolomycosis
Basidiobolomycosis is a fungal disease caused by Basidiobolus ranarum.[1][5] It may appear as one or more painless firm nodules in the skin which becomes purplish with an edge that appears to be slowly growing outwards.[3][5] A serious but less common type affects the stomach and intestine, which usually presents with tummy ache, fever and a lump.[3]
| Basidiobolomycosis | |
|---|---|
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| Basidiobolus ranarum: causative organism | |
| Specialty | Infectious disease[1] |
| Symptoms | Firm painless nodule in skin,[2] tummy upset[3] |
| Complications | Spread to local structures[2] |
| Usual onset | Gradual/slow[2] |
| Causes | B. ranarum[2] |
| Diagnostic method | Medical imaging, biopsy, microscopy, culture, histopathology[2] |
| Differential diagnosis | Inflammatory bowel disease[2] |
| Treatment | Antifungals, surgery[4] |
| Medication | Amphotericin B[4] |
| Frequency | Rare[3] |
B. ranarum, can be found in soil, decaying vegetables and has been isolated from insects, some reptiles, amphibians, and mammals.[2] The disease results from direct entry of the fungus through broken skin such as an insect bite or trauma, or eating contaminated food.[1][3] It generally affects people who are well.[2]
Diagnosis is by medical imaging, biopsy, microscopy, culture and histopathology.[2] Treatment usually involves amphotericin B and surgery.[3][4]
Although B. ranarum is found around the world, the disease Basidiobolomycosis is generally reported in tropical and subtropical areas of Africa, South America, Asia and Southwestern United States.[3] It is rare.[3] The first case in a human was reported from Indonesia as a skin infection in 1956.[4]
Signs and symptoms
Basidiobolomycosis may appear as a firm nodule in the skin which becomes purplish with an edge that appears to be slowly growing outwards.[3][5] It is generally painless but may feel itchy or burning.[3][5] There can be one lesion or several, and usually on the arms or legs of children.[5] Pus may be present if a bacterial infection also occurs.[3] The infection can spread to nearby structures such as muscles, bones and lymph nodes.[2]
A serious but less common type affects the stomach and intestine, which usually presents with tummy ache, fever and a lump.[3][6] Lymphoedema may occur.[3][4]
Mechanism
Basidiobolomycosis is a type of Entomophthoromycosis, the other being conidiobolomycosis, and is caused by Basidiobolus ranarum, a fungus belonging to the order Entomophthorales.[2] B. ranarum has been found in soil, decaying vegetables and has been isolated from insects some reptiles, amphibians, and mammals.[2] The disease results from direct entry of the fungus through broken skin such as an insect bite or trauma, or eating contaminated food.[1][3] Diabetes may be a risk factor.[3] The exact way in which infection results is not completely understood.[3]
Diagnosis
Diagnosis is by culture and biopsy.[4]
A review in 2015 showed that the most common finding on imaging of the abdomen was a mass in the bowel, the liver, or multiple sites and bowel wall thickening. Initially, many were considered to have either a cancer of the bowel or Crohns disease.[7][8]
Treatment
Treatment usually involves itraconazole or amphotericin B, combined with surgical debridement.[4] Bowel involvement may be better treated with voriconazole.[2]
Epidemiology
The condition is rare but emerging.[3] Men and children are affected more than females.[3] The disease is generally reported in tropical and subtropical areas of Africa, South America, Asia and several cases in Southwestern United States.[2][3]
History
The first case in a human was reported from Indonesia as a skin infection in 1956.[4] In 1964, the first case involving stomach and intestine was reported.[4]
Society and culture
Cases among gardeners in Arizona, US, may indicate an occupational hazard, but is unproven.[4]
Other animals
Basidiobolomycosis has been reported in a dog.[9]
References
- Al Jarie, A.; Al Azraki, T.; Al Mohsen, I.; Al Jumaah, S.; Almutawa, A.; Mohd Fahim, Y.; Al Shehri, M.; Abu Dayah, A.; Ibrahim, A.; Maw Shabana, M.; Rezk Abd-Elwahed Hussein, M. (March 2011). "Basidiobolomycosis: Case series". Journal de Mycologie Médicale. 21 (1): 37–45. doi:10.1016/j.mycmed.2010.11.002. ISSN 1156-5233. PMID 24451502.
- Queiroz-Telles, Flavio; Fahal, Ahmed Hassan; Falci, Diego R.; Caceres, Diego H.; Chiller, Tom; Pasqualotto, Alessandro C. (November 2017). "Neglected endemic mycoses". The Lancet. Infectious Diseases. 17 (11): e367–e377. doi:10.1016/S1473-3099(17)30306-7. ISSN 1474-4457. PMID 28774696.
- Bering, Jamie; Mafi, Neema; Vikram, Holenarasipur R. (May 2018). "Basidiobolomycosis: an unusual, mysterious, and emerging endemic fungal infection". Paediatrics and International Child Health. 38 (2): 81–84. doi:10.1080/20469047.2018.1458772. ISSN 2046-9055. PMID 29846151. S2CID 44181507.
- Geramizadeh, Bita; Heidari, Mina; Shekarkhar, Golsa (March 2015). "Gastrointestinal Basidiobolomycosis, a Rare and Under-diagnosed Fungal Infection in Immunocompetent Hosts: A Review Article". Iranian Journal of Medical Sciences. 40 (2): 90–97. ISSN 0253-0716. PMC 4359942. PMID 25821287.
- "ICD-11 - ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Retrieved 22 May 2021.
- Pezzani, Maria Diletta; Di Cristo, Valentina; Parravicini, Carlo; Sonzogni, Angelica; Tonello, Cristina; Franzetti, Marco; Sollima, Salvatore; Corbellino, Mario; Galli, Massimo; Milazzo, Laura; Antinori, Spinello (September 2019). "Gastrointestinal basidiobolomycosis: An emerging mycosis difficult to diagnose but curable. Case report and review of the literature". Travel Medicine and Infectious Disease. 31: 101378. doi:10.1016/j.tmaid.2019.01.013. hdl:2434/635956. ISSN 1873-0442. PMID 30660554. S2CID 58539656.
- Flicek, Kristina T.; Vikram, Holenarasipur R.; De Petris, Giovanni D.; Johnson, C. Daniel (February 2015). "Abdominal imaging findings in gastrointestinal basidiobolomycosis". Abdominal Imaging. 40 (2): 246–250. doi:10.1007/s00261-014-0212-z. ISSN 1432-0509. PMID 25099255. S2CID 23728364.
- Elzein, Fatehi; Mursi, Mohammed; Albarrag, Ahmed M.; Alfiaar, Abdullah; Alzahrani, Abdulaziz (7 August 2018). "Disseminated angioinvasive basidiobolomycosis with a favourable outcome". Medical Mycology Case Reports. 22: 30–34. doi:10.1016/j.mmcr.2018.08.001. ISSN 2211-7539. PMC 6097276. PMID 30128269.
- OKADA, Kazuki; AMANO, Shinjiro; KAWAMURA, Yoshio; KAGAWA, Yumiko (October 2015). "Gastrointestinal basidiobolomycosis in a dog". The Journal of Veterinary Medical Science. 77 (10): 1311–1313. doi:10.1292/jvms.15-0177. ISSN 0916-7250. PMC 4638302. PMID 25960121.