Shreef Khalid, Saleem Mervat, Saeedd Mayssa Adballah, Eissa Mohamed
Department of Pediatric Surgery, Zagazig University Hospital, Zagazig, Egypt.
Department of Pediatric Surgery, King Fahd Armed Forces Hospital Southern Region, Khamis Mushayt, Asser, Saudi Arabia.
Eur J Pediatr Surg. 2018 Apr;28(2):194-199. doi: 10.1055/s-0037-1598104. Epub 2017 Feb 6.
Gastrointestinal basidiobolomycosis (GIB) is an emerging fungal infection in children that leads to diagnostic confusion.
Our study aim was twofold: a systematic review of published literature and an update of some Saudi Arabia hospital series to analyze their as well as our own experience in diagnosis and management of GIB.
This clinical study included 18 children whose final diagnosis was GIB. The patients, who ranged in age from 5 to 10 years, were admitted between November 2009 and November 2015 with vague abdominal pains with or without abdominal masses for further investigation.
Abdominal pain was the most common presenting symptom (94.4%) followed by constipation and abdominal mass (83.3 and 77.8%, respectively); fever was present in only 22.2% of the cases. Elevated inflammatory markers and eosinophilia (94.4%) appeared as prominent laboratory findings.
We conclude that diagnosing GIB in children requires a high index of suspicion, awareness, and consideration of its possibility in the differential diagnosis in patients with abdominal masses and eosinophilia, particularly in areas where it is endemic. Increased awareness of this clinical entity, early surgical resection of the infected tissue, and prolonged treatment with itraconazole offer the best chance for curing the disease.
胃肠道蛙粪霉病(GIB)是一种在儿童中逐渐出现的真菌感染,会导致诊断混淆。
我们的研究目的有两个:对已发表文献进行系统综述,并更新一些沙特阿拉伯医院的病例系列,以分析他们以及我们自己在GIB诊断和管理方面的经验。
这项临床研究纳入了18名最终诊断为GIB的儿童。这些患者年龄在5至10岁之间,于2009年11月至2015年11月期间因不明原因腹痛(伴有或不伴有腹部肿块)入院进行进一步检查。
腹痛是最常见的首发症状(94.4%),其次是便秘和腹部肿块(分别为83.3%和77.8%);仅22.2%的病例出现发热。炎症标志物升高和嗜酸性粒细胞增多(94.4%)是突出的实验室检查结果。
我们得出结论,在儿童中诊断GIB需要高度的怀疑指数、意识,并在腹部肿块和嗜酸性粒细胞增多的患者鉴别诊断中考虑其可能性,特别是在该病流行的地区。提高对这种临床实体的认识、早期手术切除感染组织以及长期使用伊曲康唑治疗为治愈该病提供了最佳机会。