Antifungal Resistant Gastrointestinal Basidiobolomycosis Without Eosinophilia: A Case Report

Abstract

Introduction: Gastrointestinal basidiobolomycosis (GIB) is an emerging fatal infection in healthy individuals with limited known signs and symptoms. Case Presentation: A 42 years old labor man was admitted to the intensive care unit (ICU) of Masih Daneshvari hospital, Tehran, Iran, with chronic abdominal pain, a fever, and suspicion to post-operative abdominal infection. The patient had undergone an appendectomy as well as a colorectal surgery and a colostomy had been placed. The histopathological study of the colon was identical for gastrointestinal basidiobolomycosis. There was no eosinophilia in the peripheral blood sample. Patients’ treatment using itraconazole, voriconazole, and amphotericin B was not successful and unfortunately, he died because of septic shock. Conclusions: GIB is an emerging and fatal fungal infection with non-specific presentation such as abdominal pain, mass, and fever in healthy individuals. Persistent leukocytosis with or without eosinophilia, resistant fever, and other signs and symptoms after surgical resection, patients job and residents are important clue and insert the basidiobolomycosis in list of differential diagnoses is most important factor to early diagnosis and treatment.