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Emergence of gastrointestinal basidiobolomycosis in the United States, with a review of worldwide cases.
- Source :
-
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2012 Jun; Vol. 54 (12), pp. 1685-91. Date of Electronic Publication: 2012 Mar 22. - Publication Year :
- 2012
-
Abstract
- Background: We examined the epidemiology, clinical manifestations, histopathology, management, and outcomes of gastrointestinal basidiobolomycosis, an uncommon manifestation of infection caused by the fungus Basidiobolus ranarum.<br />Methods: In this retrospective observational cohort study, cases of gastrointestinal basidiobolomycosis in the United States were identified by reviewing medical records from Mayo Clinic Hospital (Phoenix, AZ) and contacting local infectious diseases specialists, pathologists, gastroenterologists, the Arizona Department of Health Services, health departments of adjacent states, the Armed Forces Institute of Pathology, and the US Centers for Disease Control and Prevention. A comprehensive literature review identified additional cases worldwide.<br />Results: Of 44 patients (mean age, 37 years [range, 2-81 years]) with gastrointestinal basidiobolomycosis, most were from the United States (19 patients [43%], of whom 17 [89%] were from Arizona) or Saudi Arabia (11 [25%]). Most (28 [64%]) were previously healthy. Common chronic medical conditions among 15 patients (34%) were diabetes mellitus (8 patients [18%]) and gastric disorders (7 [16%]). Common findings were abdominal pain (37 patients [84%]) and a palpable abdominal mass (19 [43%]). Intraabdominal malignancy was the leading provisional diagnosis (19 patients [43%]). The large bowel was involved in 36 (82%), the small intestine in 16 (36%), and the liver or gallbladder in 13 (30%). Characteristic histopathologic findings were observed in 43 (98%). Eight patients (18%) died. Combined surgical intervention and antifungal therapy was the preferred treatment.<br />Conclusions: Gastrointestinal basidiobolomycosis is an emerging invasive fungal infection in desert regions of the US Southwest. Clinical findings mimic malignancy and inflammatory bowel disease. Surgical excision and prolonged antifungal therapy are associated with favorable outcomes.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Antifungal Agents therapeutic use
Arizona epidemiology
Child
Child, Preschool
Communicable Diseases, Emerging diagnosis
Communicable Diseases, Emerging epidemiology
Communicable Diseases, Emerging microbiology
Communicable Diseases, Emerging therapy
Desert Climate
Digestive System Surgical Procedures methods
Gastrointestinal Diseases diagnosis
Gastrointestinal Diseases therapy
Humans
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Young Adult
Zygomycosis diagnosis
Zygomycosis therapy
Entomophthorales isolation & purification
Gastrointestinal Diseases epidemiology
Gastrointestinal Diseases microbiology
Zygomycosis epidemiology
Zygomycosis microbiology
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6591
- Volume :
- 54
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
- Publication Type :
- Academic Journal
- Accession number :
- 22441651
- Full Text :
- https://doi.org/10.1093/cid/cis250