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BMJ Case Rep ; 12(1)2019 Jan 29.
Article in English | MEDLINE | ID: mdl-30700449

ABSTRACT

Basidiobolomycosis is a rare fungal infection that may affect the gastrointestinal tract. It is caused by Basidiobolus ranarum and less than 80 cases have been reported in the literature. The incidence seems to be higher in the Middle East and in particular Saudi Arabia where most cases are diagnosed in the south-western region. An 18-year-old woman presented to the emergency department with an obstructing caecal mass initially suspected to be malignant. Surgical resection was complicated by bowel perforation, histology and cultures confirmed basidiobolomycosis infection. The postoperative course was complicated by an enterocutaneous fistula, fungal intra-abdominal abscesses, liver and lung abscesses, formation of mycotic hepatic artery aneurysm and meningoencephalitis. The patient eventually expired due to sepsis despite aggressive treatment. Diagnosis and management of such rare cases are very challenging and require a multidisciplinary approach. Complications are common and associated with a high mortality.


Subject(s)
Aneurysm, Infected/complications , Colonic Neoplasms , Entomophthorales/isolation & purification , Intestinal Obstruction/complications , Intestinal Perforation/complications , Zygomycosis/complications , Adolescent , Aneurysm, Infected/diagnostic imaging , Aneurysm, Infected/microbiology , Diagnosis, Differential , Fatal Outcome , Female , Gastrointestinal Tract/diagnostic imaging , Gastrointestinal Tract/microbiology , Humans , Intestinal Obstruction/diagnostic imaging , Intestinal Perforation/diagnosis , Intestines , Saudi Arabia , Sepsis/complications , Sepsis/diagnosis , Tomography, X-Ray Computed/methods , Zygomycosis/diagnosis
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