Mahmoud Waleed, Khawar Mahwish, Petkar Mahir, Odaippurath Thasneem, Kurer Mohamed
General Surgery, Hamad Medical Corporation, Doha, QAT.
Colorectal Surgery, Hamad Medical Corporation, Doha, QAT.
Cureus. 2022 Jun 21;14(6):e26157. doi: 10.7759/cureus.26157. eCollection 2022 Jun.
is a rare fungal infection caused by saprophyte . It is rarely seen in healthy adult patients; however, it usually affects children. The commonly involved sites are skin and subcutaneous tissue, mostly found in the Middle East and the southwestern United States. The diagnosis is challenging because of the lack of specific clinical presentation and the absence of predisposing factors. In our case report, we discuss a 38-year-old male patient who presented with a 2-months history of right lower quadrant pain. Initially, his pain was intermittent and gradually increased in intensity; it localized to the right lower quadrant and radiated to the right flank region. No relieving or aggravating factors were noted. In addition, the patient mentioned a history of constipation, weight loss, decreased appetite, and vomiting-however, no history of fever, night sweats, trauma, or recent travel. The diagnosis was made based on computerized tomography (CT) guided biopsy of the mass, illustrating the findings of fungal hyphae with a gradual increase in the eosinophilic count since admission. The patient was managed using a combined medical and surgical approach, including surgical debulking of the mass and a well-monitored course of anti-fungal therapy. Gastrointestinal basidiobolomycosis infection (GBI) can present in many forms, with an increasing potential to invade the colon, ultimately forming an inflamed mass. Nonetheless, the presence of a mass invading the colon, adjacent vessels, and a retroperitoneal area, along with an increase in the number of eosinophil count in the Middle East region, should raise the suspicion of basidiobolomycosis fungal infection.
是一种由腐生菌引起的罕见真菌感染。在健康成年患者中很少见;然而,它通常会影响儿童。常见受累部位是皮肤和皮下组织,多见于中东和美国西南部。由于缺乏特异性临床表现且无易感因素,诊断具有挑战性。在我们的病例报告中,我们讨论了一名38岁男性患者,他有2个月的右下腹疼痛病史。起初,他的疼痛是间歇性的,强度逐渐增加;疼痛局限于右下腹并放射至右胁腹区域。未发现缓解或加重因素。此外,患者提到有便秘、体重减轻、食欲减退和呕吐史——然而,无发热、盗汗、外伤或近期旅行史。诊断基于计算机断层扫描(CT)引导下对肿块的活检,显示有真菌菌丝的表现,自入院以来嗜酸性粒细胞计数逐渐增加。患者采用药物和手术联合治疗方法,包括对肿块进行手术减瘤以及密切监测的抗真菌治疗疗程。胃肠道担子菌病感染(GBI)可表现为多种形式,侵袭结肠的可能性增加,最终形成炎性肿块。尽管如此,在中东地区出现侵袭结肠、邻近血管和腹膜后区域的肿块,以及嗜酸性粒细胞计数增加,应引起对担子菌病真菌感染的怀疑。