Case Report: Gastrointestinal Basidiobolomycosis with Multi-Organ Involvement Presented with Intussusception

AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE - Tập 105 Số 5 - Trang 1222-1226 - 2021
Zahra Jafarpour1, Gholamreza Pouladfar1, Alireza Dehghan2, Mohammad Hossein Anbardar3, Hamid Reza Foroutan4
11Professor Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
22Radiology Department, Shiraz University of Medical Sciences, Shiraz, Iran;
33Pathology Department, Shiraz University of Medical Sciences, Shiraz, Iran;
44Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

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ABSTRACT. Gastrointestinal basidiobolomycosis (GIB) is a rare, life-threatening fungal infection affecting immunocompetent individuals in tropical and subtropical regions. A diverse presentation of GIB has been reported, but no report has yet been published on intussusception. We describe a 23-month-old immunocompetent boy from a subtropical area in Iran who presented with intussusception. Prolonged fever, an abdominal mass, hepatomegaly, high erythrocyte sedimentation rate, and peripheral eosinophilia strongly suggested GIB. Accordingly, GIB was diagnosed based on the characteristic histopathology (the Splendore-Hoeppli phenomenon) detected in a liver sample taken via biopsy. Exploratory laparotomy showed several organs, including the colon, gall bladder, liver, and abdominal wall, were involved. Antifungal therapy with trimethoprim/sulfamethoxazole, liposomal amphotericin B, a saturated solution of potassium iodide, and surgical resection of involved tissues were used with improved outcome. The presence of non-septate fungal hyphal elements in the colonic mucosa led to the thickening of the bowel wall, leading to secondary intussusception.

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AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE

Tập 105 Số 5

1222-1226

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