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Case Report: Gastrointestinal Basidiobolomycosis with Multi-Organ Involvement Presented with Intussusception

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  • 1 Professor Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
  • | 2 Radiology Department, Shiraz University of Medical Sciences, Shiraz, Iran;
  • | 3 Pathology Department, Shiraz University of Medical Sciences, Shiraz, Iran;
  • | 4 Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

ABSTRACT.

Gastrointestinal basidiobolomycosis (GIB) is a rare, life-threatening fungal infection affecting immunocompetent individuals in tropical and subtropical regions. A diverse presentation of GIB has been reported, but no report has yet been published on intussusception. We describe a 23-month-old immunocompetent boy from a subtropical area in Iran who presented with intussusception. Prolonged fever, an abdominal mass, hepatomegaly, high erythrocyte sedimentation rate, and peripheral eosinophilia strongly suggested GIB. Accordingly, GIB was diagnosed based on the characteristic histopathology (the Splendore-Hoeppli phenomenon) detected in a liver sample taken via biopsy. Exploratory laparotomy showed several organs, including the colon, gall bladder, liver, and abdominal wall, were involved. Antifungal therapy with trimethoprim/sulfamethoxazole, liposomal amphotericin B, a saturated solution of potassium iodide, and surgical resection of involved tissues were used with improved outcome. The presence of non-septate fungal hyphal elements in the colonic mucosa led to the thickening of the bowel wall, leading to secondary intussusception.

Author Notes

Address correspondence to Gholamreza Pouladfar, Professor Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. E-mail: pouladfar_ghr@hotmail.com

Authors’ addresses: Zahra Jafarpour and Gholamreza Pouladfar, Professor Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran, E-mails: zjafarpoor54@yahoo.com and pouladfar_ghr@hotmail.com. Alireza Dehghan, Radiology Department, Shiraz University of Medical Sciences, Shiraz, Iran, E-mail: alirezadehghan@sums.ac.ir. Mohammad Hossein Anbardar, Pathology Department, Shiraz University of Medical Sciences, Shiraz, Iran, E-mail: anbardarm@sums.ac.ir. Hamid Reza Foroutan, Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, E-mail: forotanh@yahoo.com.

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