Intestinal obstruction due to Basidiobolus ranarum: An unusual case.

A case of intestinal obstruction caused by extensive soft tissue fungal infection of the perineum due to Basidiobolus ranarum is presented here. There was excellent response to antifungal treatment. A literature search revealed the case report of intestinal obstruction due to intrinsic mucosal involvement by the fungus, but extensive soft tissue involvement of the perineum resulting in extraneous obstruction to the rectum, has not been reported so far.

Nódulos pulmonares cavitados y vasculitis ANCA asociada: secundarios a infección por zigomicetos / Cavitated pulmonary nodules and associated ANCA vasculitis: secondary to zygomycetes infection

La presencia de nódulos pulmonares cavitados nos obliga a plantear varios diagnósticos diferenciales. El diagnóstico definitivo hay que definirlo en base a lo que nos aportan los exámenes serológicos, imagenológicos e histológicos, y correlacionar con la forma de presentación clínica. Un diagnóstico importante que debe ser considerado es la Granulomatosis de Wegener (GW) que corresponde a una vasculitis, en la mayoría de los casos sistémica y en la que encontramos anticuerpos anticitoplasma de neutrófilos de histología compatible con vasculitis. Las patologías infecciosas son otra causa importante de lesiones nodulares en pulmón. Si estamos ante pacientes con algún grado de inmunosupresión, no debemos olvidar la etiología micótica y dentro de esta la infección causada por hongos del grupo Zigomicetes (mucormicosis), sobre todo por la urgencia de realizar tratamiento agresivo y su alta mortalidad.

The presence of cavitated pulmonary nodules obliges one to pose various differential diagnoses. A definite diagnosis must be defined based on serological, imagenological and histological exams, and contrast these with the clinical manifestation. An important diagnosis that must be considered is Wegener’s granulomatosis, which corresponds to a Vasculitis, usually systemic, in which we find antineutrophil cytoplasmic antibodies and histology compatible with Vasculitis. Infectious pathologies are an important cause of pulmonary nodular lesions. If faced with a patient with a degree of immunosuppression, we must not forget the mycotic etiology, and within this the infection caused by fungi from the Zygomycetes group (mucomycosis), above all due to the urgency of aggressive treatment and its high mortality rate.

Multiple discharging sinuses: an unusual presentation caused by Absidia corymbifera.

A case of zygomycosis presenting with non-healing multiple discharging sinuses in a diabetic patient is reported here. The debrided tissue on histopathological examination revealed dense infiltration with aseptate fungal hyphae. Potassium hydroxide mount showed hyaline aseptate hyphae suggestive of zygomycosis. On culture, Absidia corymbifera was isolated. The patient responded to surgical debridement and therapy with amphotericin B followed by itraconazole.

Gastric zygomycosis--an unusual cause of massive upper gastrointestinal bleed.

We report a 62-year-old man with cardiac failure and acute renal failure, who had massive hematemesis. Upper GI endoscopy showed a large gastric lesser curvature ulcer. Billroth II gastrectomy specimen showed fungal invasion. He received amphotericin B postoperatively, and recovered uneventfully.

Presumably entomophthoramycosis in an HIV-infected patient: the first in Thailand.

The authors reported the case of a symptomatic HIV-infected woman with a slowly progressive infiltrative lesion which invaded in and around the nasal cavity over a 6-month period. Physical examination showed erythematous to violaceous plaques at the nasal and malar areas. Swelling of the inferior turbinate was noted in the right nare. Skin biopsy of the involved area revealed multiple nonseptate, broad, thin-walled hyphae within giant cells and granulomata. Entomophthoramycosis was diagnosed based on clinical features and histopathology. She was treated with intravenous amphotericin B for two weeks, followed by oral itraconazole 400 mg daily. At six months there was complete resolution of all lesions.