Aljohani Alaa Eid, Alshemesi Bandar, Alshubaisheri Abdullatif, Alkraidis Abdulmajeed, Alzahrani Ali, Sairafi Rami
General Surgery Department, Security Forces Hospital, Riyadh, Saudi Arabia.
General Surgery Department, Security Forces Hospital, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2020;77:762-765. doi: 10.1016/j.ijscr.2020.11.054. Epub 2020 Nov 24.
Gastrointestinal basidiobolomycosis (GIB) is an uncommon fungal infection caused byBasidiobolus ranarum, with less than 80 cases reported in the literature.
A 36-year-old woman presented with colicky upper abdominal pain for 2 months and inability to pass stool for 2 days. Computed tomography of the abdomen and colonoscopy both showed a mass in the transverse colon. Colonoscopic biopsy suggested a zygomycosis. Laparotomy revealed a perforated mass in the transverse colon; the mass also involved the small bowel and stomach. En bloc resection was performed, and the incision was closed for a second-look procedure. The patient was admitted to the intensive care unit and placed on a ventilator and inotropes; however, her condition deteriorated, and she died on day 24 post admission. The histopathology report (obtained after the patient's death) was consistent with GIB.
Gastrointestinal basidiobolomycosis presents with nonspecific signs and symptoms and so the diagnosis is easily missed or delayed. Timely, accurate diagnosis is crucially important, especially when there is intestinal obstruction and sepsis. Persistent severe abdominal pain in a patient with neutropenia should alert the physician to the possibility of a fungal infection. There are reports from several countries of basidiobolomycosis in immunocompetent hosts. The disease shows no age predilection, but males may be more susceptible. Treatment is with surgical debridement and antifungal drugs-ideally the lipid formulation of amphotericin B.
Gastrointestinal basidiobolomycosis is a rare infection that can be fatal if not diagnosed and treated early.
胃肠道蛙粪霉病（GIB）是一种由蛙粪霉引起的罕见真菌感染，文献报道的病例不足80例。
一名36岁女性出现上腹部绞痛2个月，2天未解大便。腹部计算机断层扫描和结肠镜检查均显示横结肠有肿物。结肠镜活检提示为接合菌病。剖腹探查发现横结肠有一穿孔性肿物；该肿物还累及小肠和胃。进行了整块切除，并关闭切口以便进行二次探查手术。患者被收入重症监护病房，使用呼吸机和血管活性药物；然而，她的病情恶化，入院后第24天死亡。组织病理学报告（在患者死后获得）与胃肠道蛙粪霉病相符。
胃肠道蛙粪霉病表现为非特异性体征和症状，因此诊断容易被漏诊或延误。及时、准确的诊断至关重要，尤其是在出现肠梗阻和脓毒症时。中性粒细胞减少患者持续出现严重腹痛应提醒医生注意真菌感染的可能性。有几个国家报道了免疫功能正常宿主发生蛙粪霉病的病例。该病无年龄倾向，但男性可能更易感染。治疗方法是手术清创和使用抗真菌药物——理想的是两性霉素B的脂质制剂。
胃肠道蛙粪霉病是一种罕见感染，若不及早诊断和治疗可能致命。
