Mohammed Mohaned, Albishri Ahmed, Alabbas Ali, Abdelmogeit Sami E, Alasmari Badriah G, Alqahtani Jameelah A, Mohammed Samah E, Hawan Ali, Hussein Mahmoud, Saeed Muhammad, Hamid Yassin, Ghazwani Eman
Pediatrics, Armed Forces Hospital Southern Region, Khamis Mushait, SAU.
Pediatric Infectious Diseases, Armed Forces Hospital Southern Region, Khamis Mushait, SAU.
Cureus. 2024 Dec 27;16(12):e76451. doi: 10.7759/cureus.76451. eCollection 2024 Dec.
Basidiobolomycosis, a rare fungal infection seen in immunocompetent patients, is a chronic granulomatous infection affecting the skin and subcutaneous tissue. It is caused by the fungus . Gastrointestinal basidiobolomycosis usually has non-specific clinical manifestations, and its diagnosis requires a high index of suspicion. In pediatric patients, any delay or misdiagnosis may lead to morbidity and or mortality. Herein, we report three cases of gastrointestinal basidiobolomycosis from the southern region of Saudi Arabia. The three patients were diagnosed based on histopathology results and computed tomography of the abdomen, with different pathological sites with multiple gastrointestinal tract involvement. Case one was a five-year-old male patient complaining of abdominal pain lasting seven months, weight loss, and fever, with computed tomography (CT) showing involvement of the liver and bowels. Case two was a five-year-old male patient complaining of a fever lasting one month associated with generalized abdominal pain, with CT abdomen showing involvement of the liver, colon, cecum, and mesenteric lymph node. Case three was a seven-year-old female patient complaining of abdominal pain lasting one month, with a CT abdomen showing involvement of the colon and terminal ilium accompanied by mesenteric lymph node involvement. In all three cases, the CT abdomen findings showed involvement of the bowel. All three cases were treated successfully with antifungal monotherapy (itraconazole) without surgical intervention, and all responded well. The aim of this case series was to show the importance of early management for improved outcomes in such cases and to highlight how a diagnosis of gastrointestinal basidiobolomycosis requires a high index of suspicion due to its broad range of clinical presentation. In addition, medical management with itraconazole can be curative without the need for surgical intervention.
担子菌病是一种在免疫功能正常的患者中罕见的真菌感染，是一种影响皮肤和皮下组织的慢性肉芽肿性感染。它由真菌引起。胃肠道担子菌病通常具有非特异性临床表现，其诊断需要高度的怀疑指数。在儿科患者中，任何延误或误诊都可能导致发病和/或死亡。在此，我们报告沙特阿拉伯南部地区的三例胃肠道担子菌病病例。这三名患者根据组织病理学结果和腹部计算机断层扫描进行诊断，病理部位不同，胃肠道多处受累。病例一是一名5岁男性患者，主诉腹痛持续7个月、体重减轻和发热，计算机断层扫描（CT）显示肝脏和肠道受累。病例二是一名5岁男性患者，主诉发热持续1个月，伴有全腹疼痛，腹部CT显示肝脏、结肠、盲肠和肠系膜淋巴结受累。病例三是一名7岁女性患者，主诉腹痛持续1个月，腹部CT显示结肠和回肠末端受累，伴有肠系膜淋巴结受累。在所有三例病例中，腹部CT检查结果均显示肠道受累。所有三例均采用抗真菌单一疗法（伊曲康唑）成功治疗，无需手术干预，且所有患者反应良好。本病例系列的目的是表明早期管理对于改善此类病例结局的重要性，并强调由于胃肠道担子菌病临床表现广泛，其诊断需要高度的怀疑指数。此外,伊曲康唑药物治疗无需手术干预即可治愈。
