Basidiobolomycosis

Basidiobolomycosis, a form of zygomycosis caused by the fungus Basidiobolus ranarum, was first isolated in 1955. It is also known as Entomophthoramycosis basidiobolae. This fungus is found worldwide in decaying vegetation, food, and soil as well as in the GI tracts of reptiles, amphibians, fish, and insectivorous bats. It is most commonly found in the tropical regions of Africa (it is endemic in Uganda), but cases have also been reported in parts of Asia, India, and South America. It has rarely caused disease in humans in the United States. In recent years, however, its geographical distribution has expanded, as has the variety of manifestations.

Causes

The disease is more common in children (80% of cases), especially young boys (3:1), and usually results from traumatic inoculation, such as insect bites, scratches, and minor cuts. Infections are also believed to be the result of lifestyle and dietary behavior. If ingested, B. ranarum can cause GI basidiobolomycosis, in which the muscular layer of the GI tract is greatly thickened. Of 15 reported cases of GI basidiobolomycosis worldwide, 5 patients had reptiles or amphibians living in or around their homes, 4 patients did not wash their fruits or vegetables prior to eating, and 3 had camped near a lake or river. Patients diagnosed with basidiobolomycosis usually do not have any underlying disease.

Complications

GI basidiobolomycosis could lead to bowel obstruction and can affect other abdominal organs. If disseminated, B. ranarum can lead to severe hypotension, shortness of breath, organ necrosis, septic shock, and death.

Assessment Findings

Basidiobolomycosis usually manifests as a painless, unilateral, well-circumscribed subcutaneous nodule on the lower extremities and buttocks, accompanied by fever. These nodules tend to grow locally and become ulcerated. (See Ulcerated nodules of basidiobolomycosis.)

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