Background

Gastrointestinal basidiobolomycosis (GIB) is a rare mycosis affecting almost exclusively immunocompetent subjects.

Methods

We describe a case of GIB caused by Basidiobolus ranarum in a 25-year-old Italian immunocompetent man resident in Ireland who presented a 2-month history of epigastric pain. Suspecting colon cancer he underwent a right hemicolectomy subsequently leading to a diagnosis of GIB by means of molecular biology. After surgery a 9-month therapy with itraconazole was employed with a good outcome. A review of medical literature regarding GIB cases published in the period 1964–2017 is presented.

Results

One-hundred and two cases of GIB were included in this analysis. The disease was observed predominantly in male gender (74.5%) and children (41.2%). Abdominal pain was the single most common complaint (86.3%) followed by fever (40.2%) and evidence of an abdominal mass (30.4%). Peripheral blood eosinophilia was detected in 85.7% of cases. Most of the patients were diagnosed in Saudi Arabia (37.2%) followed by USA (21.6%) and Iran (20.6%). Surgery plus antifungal therapy was employed in the majority of patients (77.5%). An unfavourable outcome was documented globally in 18.6% of patients.

Conclusions

GIB seems to be an emerging intestinal mycosis among immunocompetent patients living in the Middle East and Arizona.

中文翻译：

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胃肠道真菌病：一种难以诊断但可以治愈的新兴真菌病。病例报告和文献复习。

背景

胃肠道芽孢杆菌病（GIB）是一种罕见的真菌病，几乎只影响具有免疫能力的受试者。

方法

我们描述了一个由Basidiobolus ranarum引起的GIB病例，该病例发生在居住在爱尔兰的25岁意大利具有免疫能力的男子中，该男子出现了2个月的上腹痛史。怀疑结肠癌，他接受了右半结肠切除术，随后通过分子生物学诊断为GIB。手术后，使用伊曲康唑治疗9个月，效果良好。本文介绍了1964-2017年间发表的有关GIB病例的医学文献。

结果

该分析包括一百零二例GIB病例。该病主要在男性（74.5％）和儿童（41.2％）中观察到。腹痛是最常见的主诉（86.3％），其次是发烧（40.2％）和腹部有肿块（30.4％）。在85.7％的病例中检测到外周血嗜酸性粒细胞增多。大多数患者被诊断为沙特阿拉伯（37.2％），其次是美国（21.6％）和伊朗（20.6％）。大多数患者（77.5％）采用手术加抗真菌治疗。全球18.6％的患者记录了不良结果。

结论

在居住在中东和亚利桑那州的具有免疫能力的患者中，GIB似乎是一种新兴的肠道真菌病。