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Gastrointestinal basidiobolomycosis found in desert regions
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The incidence of the fungal infection gastrointestinal basidiobolomycosis in the United States appears to be most common in desert regions. Researchers suggest for further research to be conducted to identify predictors of poor outcomes among those affected and the possible environmental reservoirs.
Researchers from the Mayo Clinic in Arizona undertook a study to examine the epidemiology, clinical manifestations, imaging findings, histopathology, management and outcomes of gastrointestinal basidiobolomycosis and emerging infection. Cases were identified at the Mayo Clinic and other institutions in the United States through March 2010.
They identified 44 cases and most were from the United States or Saudi Arabia. Seventeen of the 19 US cases were from Arizona. The most common symptoms were abdominal pain, which occurred in 37 patients, and palpable abdominal mass, which occurred in 19 patients. The colon and rectum were involved in 36 patients.
On computed tomography scan, a mass in the colon was the most common finding. In laboratory findings, peripheral blood eosinophilia was found in 26 patients. Four isolates of Basidiobolus were identified, and all four isolates were susceptible to itraconazole.
Most patients had the mass surgically removed, and 37 patients received antifungal therapy. The mean duration of therapy was 8 months. Four of the six patients who did not receive antifungal therapy died. After a mean follow-up of 1.53 years, 33 patients were still alive.
“Awareness of its clinical presentation, radiographic and endoscopic findings and characteristic histopathologic findings can facilitate prompt diagnosis and initiation of effective antifungal therapy,” the researchers wrote.
For more information:
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Vikram HR. Clin Infect Dis. 2012;54:1685-1691.
Disclosures:
- The researchers report no relevant financial disclosures.