Figure - available from: Journal of Clinical Microbiology
This content is subject to copyright. Terms and conditions apply.
(A, B, and C) Sporangiospores of B. ranarumshowing cleavage formation to produce meristospores (black arrow), knob-like adhesive tip (white arrow), and ballistospores with hyphal tag (white arrowhead). (D) Thick-walled zygospores. (E) A zygospore with a beak. Magnifications, ×400.
Source publication
Basidiobolus ranarum is a known cause of subcutaneous zygomycosis. Recently, its etiologic role in gastrointestinal infections has been increasingly recognized. While the clinical presentation of the subcutaneous disease is quite characteristic and the disease is easy to diagnose, gastrointestinal basidiobolomycosis poses diagnostic difficulties; i...
Citations
... Laboratory findings that should raise the suspicion of GIB consist of leukocytosis, marked eosinophilia, and elevated ESR as observed in all our reported cases [9,15]. Serologic tests, such as enzyme-linked immunosorbent assay or immunodiffusion, have shown promise for the presumptive diagnosis of GIB, particularly when used with proper controls [9,16]. Radiological imaging modalities such as CT or MRI show characteristic findings of multiple masses with surrounding inflammatory components like soft tissue stranding and bowel wall thickening. ...
... Furthermore, the emergence of resistance to certain antifungal agents, such as amphotericin B, itraconazole, and fluconazole, underscores the importance of susceptibility testing and the consideration of alternative antifungal agents [16]. As exemplified in our reported cases of GIB, all patients had combined antifungal and surgical resection. ...
Gastrointestinal basidiobolomycosis (GIB) is a rare fungal infection caused by Basidiobolus ranarum, a saprophytic fungus that belongs to the class of Basidiobolomycetes. It mainly infects immunocompetent individuals and is mainly found in arid tropical and subtropical regions, including Southwestern America, Saudi Arabia, Africa, and Asia. Not surprisingly, a great number of human infections have been reported from these warm, humid climate regions that are felicitous for the growth of this fungus, especially from the southern region of Saudi Arabia and Arizona in the United States of America. GIB is easily misdiagnosed as malignancy, inflammatory bowel disease, diverticulitis, lymphoma, and chronic intestinal infections due to its rarity. In this case series, we summarize the clinical features, imaging, histopathological features, and treatment of patients diagnosed with GIB in our institution.
... As of 2018, approximately 122 basidiobolomycosis cases have been reported worldwide, with most from Middle Eastern countries (ie, Iran, Saudi Arabia, and Kuwait) [ 7 ,8 ]. Available data indicates males may be more susceptible than females [9] , but there is no specific age group associated with GIB, as reported ages range from 1.5 years to 80 years [2] . ...
Gastrointestinal basidiobolomycosis is an unusual fungal infection caused by Basidiobolus ranarum, a saprophytic fungus primarily found in soil and decaying vegetables. Basidiobolomycosis typically presents as a chronic subcutaneous swelling and rarely infects the gastrointestinal tract. Thus, the infrequency of gastrointestinal infections, along with nonspecific clinical symptoms, often results in misdiagnosed cases and delays in treatment. In this article, we report the case of a 68-year-old male with gastrointestinal basidiobolomycosis masquerading as metastatic cancer. We focus on the use of radiological imaging modalities and histopathological analysis to optimize the diagnosis and treatment of this rare gastrointestinal infection.
... Basidiobolomycosis is a type of fungal infection caused by pathogenic Basidiobolus ranarum, which belongs to the newly created phylum Entomophthoromycota due to its zoonotic nature (Hung et al. 2020;Acosta-España and Voigt 2022). Basidiobolus species inhabit the soil and dead organic matter worldwide, and are categorized as saprophytes and opportunists (Khan et al. 2001). They generally cause cutaneous or subcutaneous lesions in immunocompetent humans and animals to lethal basidiobolomycosis (Eurico de et al. 1980;Khan et al. 2001;Ageel et al. 2017;Bshabshe et al. 2020). ...
... Basidiobolus species inhabit the soil and dead organic matter worldwide, and are categorized as saprophytes and opportunists (Khan et al. 2001). They generally cause cutaneous or subcutaneous lesions in immunocompetent humans and animals to lethal basidiobolomycosis (Eurico de et al. 1980;Khan et al. 2001;Ageel et al. 2017;Bshabshe et al. 2020). The emergence of Basidiobolus infections has been observed worldwide. ...
This study represents the molecular characterization of Basidiobolus sp., isolated from gastrointestinal basidiobolomycosis in rainbow trout, Oncorhynchus mykiss in India. Basidiobolus spp. is a zoonotic fungal pathogen that can cause gastrointestinal, cutaneous or subcutaneous, visceral and colonic basidiobolomycosis in immunocompetent individuals of all genders and ages. The strain was recovered from ascitic fluid of moribund rainbow trout, which upon necropsy exhibited liquefaction and swelling of internal organs, as well as red-yellow drainable and foul-smelling ascites (150.5 ± 15.9 mL). The ascitic fluid was subjected to microscopic analysis, which revealed the presence of irregular, spore-forming fungal hyphae characterized by large size and sparse septation, with a diameter of 25.6 ± 4.9 µm and thin walls. Additionally, thick-walled zygospores measuring 35.9 ± 7.9 µm in diameter, exhibiting a single outer beak-like projection on the spore surface, were also detected. Furthermore, examination of the 72-h-old fungal culture displayed a furrowed, waxy colony with a raised center and flat edges, indicative of its unique morphology. The isolate demonstrated β-hemolysis and the capability to degrade protein, nucleic acid, gelatin, urea, and lipid. The amplification of RNA internal transcribed spacer (ITS) for amplicon size of 680 bp, phylogenetic analysis, calculation of genetic distance similarity (%), and haplotype networking confirmed that the isolate was Basidiobolus sp. Ind SN1 (MW 928426). Basidiobolus sp. Ind SN1 shared 97.82%, 96.59%, and 92.32% sequence similarity with Basidiobolus meristosporus (MH857419), B. meristosporus (FJ786040), and B. heterosporus (EF392521), respectively. The disease caused by Basidiobolus sp. Ind SN1 was successfully reproduced in rainbow trout through experimental infection, satisfying Koch’s postulate. Histopathological examination of the liver, kidney, and gill of the infected rainbow trout revealed hydropic degeneration of hepatocytes, necrotic kidney tubules, and lamellar hyperplasia, respectively. This study also identifies rainbow trout as a novel host for Basidiobolus sp., highlighting the emergence of a fungal pathogen that could potentially lead to fatal infections in fish farming systems. Thus, it is recommended that fish culturists, aquaculture entrepreneurs, and fish handlers should maintain proper sanitation and good animal husbandry practices to minimize the risk of basidiobolomycosis in aquaculture.
... For example, members of the entomophthoralean fungi can cause infection in both insects and mammals, not only in immunocomprised patients, but also reported from immunocompetent individuals due to insect bites or other undetermined environmental contacts, especially in tropical and subtropical regions (Vilela and Mendoza 2018). Basidiobolus and Conidiobolus are two additional agents of human skin, subcutaneous, and gastrointestinal infections (Khan et al. 2001;Shaikh et al. 2016). Basidiobolus can be isolated from various types of environments, including soils or leaf litters, dung of frogs or lizards, and various insects (e.g., mosquitoes, mites, and springtails) (Lyon et al. 2001;Garros et al. 2008;Manning and Callaghan 2008;Werner et al. 2012). ...
Fungi have evolved over millions of years and their species diversity is predicted to be the second largest on the earth. Fungi have cross-kingdom interactions with many organisms which have mutually shaped their evolutionary trajectories. Zygomycete fungi hold a pivotal position in the fungal tree of life and provide important perspectives on the early evolution of fungi from aquatic to terrestrial environments. Phylogenomic analyses have found that zygomycete fungi diversified into two separate clades, the Mucoromycota which are frequently associated with plants and Zoopagomycota that are commonly animal-associated fungi. Genetic elements that contributed to the fitness and divergence of these lineages may have been shaped by the varied interactions these fungi have had with plants, animals, bacteria and other microbes. To investigate this, we performed comparative genomic analyses of the two clades of zygomycetes in the context of Kingdom Fungi, benefiting from our generation of a new collection of zygomycete genomes, including nine produced for this study. We identified lineage-specific genomic content which may contribute to the disparate biology observed in these zygomycetes. Our findings include the discovery of undescribed diversity in CotH, a Mucormycosis pathogenicity factor, which was found in a broad set of zygomycetes. Reconciliation analysis identified multiple duplication events and an expansion of CotH copies throughout the Mucoromycotina, Mortierellomycotina, Neocallimastigomycota, and Basidiobolus lineages. A kingdom-level phylogenomic analysis also identified new evolutionary relationships within the sub-phyla of Mucoromycota and Zoopagomycota, including supporting the sister-clade relationship between Glomeromycotina and Mortierellomycotina and the placement of Basidiobolus as sister to other Zoopagomycota lineages.
... Food contamination with Basidiobolus spp. may lead to gastrointestinal infections (Khan et al., 2001). Clinical symptoms include abdominal pain, intermittent lowgrade fever, vomiting, bloody mucosal diarrhea, intestinal bleeding, gastric or intestinal ulceration, abdominal distension, obstructive symptoms, etc., (Costa, 2012;Mendoza et al., 2015;Elzein et al., 2018;Omar Takrouni et al., 2019). ...
Fungal diseases were underestimated for many years. And the global burden of fungal infections is substantial and has increased in recent years. Invasive fungal infections have been linked to several risk factors in humans which basically depend on the individual homeostasis of the patients. However, many fungi can infect even apparently healthy people. Knowledge of these pathogens is critical in reducing or stopping morbidity and/or mortality statistics due to fungal pathogens.
Successful therapeutic strategies rely on rapid diagnosis of the causative fungal agent and the underlying disease. However, the terminology of the diseases was updated to existing phylogenetic classifications and led to confusion in the definition of mucormycosis, conidiobolomycosis, and basidiobolomycosis, which were previously grouped under the now-uncommon term zygomycosis. Therefore, the ecological, taxonomic, clinical, and diagnostic differences are addressed to optimize the understanding and definition of these diseases. The term ‘coenocytic hyphomycosis’ is proposed to summarize all fungal infections caused by Mucorales and species of Basidiobolus and Conidiobolus
... Basidiobolus is a fungus belonging to the zygomycetes class found in great abundance in the environment [1,2]. Even though it is more common in the tropical and subtropical regions of the globe, some studies reported that this fungus was isolated in places where the disease has not been reported, such as the northeastern parts of the United States and Australia. ...
... B. ranarum has also been isolated in insects, dogs, bats, horses, and humans. The first reported case Open Access *Correspondence: dr.aljohani@live.com of this disease was a subcutaneous infection in 1956 [1,2]. A review conducted in 2019 stated that fewer than 80 cases had been reported by 2019, of which 17 were reported between 2009 and 2014. ...
... B. ranarum is commonly found in the soil; therefore, gardeners, farmers, and landscapers are exposed to B. ranarum more than the rest of the population [3,5]. Pediatric GIB is an unusual fungal infection caused by B. ranarum [1,2,6]. Typically, this organism causes subcutaneous, sinus, and nasal infection, and rarely causes a soft tissue tumor-like mass of the bowel. ...
Background
Pediatric gastrointestinal basidiobolomycosis is an unusual fungal infection caused by Basidiobolus ranarum , an environmental saprophyte found worldwide. Typically, basidiobolomycosis presents as a subcutaneous infection or soft tissue tumor-like lesion, and rarely involves the gastrointestinal tract. Gastrointestinal basidiobolomycosis is most common in young infants. It has no definitive clinical presentation, and almost all cases are misdiagnosed during the initial presentation.
Case presentation
We report the case of a 4-year-old Saudi boy who presented to the emergency department with abdominal pain, nausea, vomiting, and weight loss. Ultrasonography revealed a target sign. Based on the ultrasonography findings, surgery was performed, which revealed the presence of intussusception. Eventually, the patient was diagnosed with intussusception secondary to intra-abdominal basidiobolomycosis based on the histological findings. The patient was readmitted and intravenous voriconazole therapy was initiated. One week after the second admission, the patient developed abdominal pain, nausea, vomiting, inability to hold down food, and constipation. Computed tomography of the abdomen was suggestive of small bowel obstruction, which was managed conservatively. The patient responded well and was subsequently discharged with a prescription of oral voriconazole.
Conclusions
This case reveals that gastrointestinal basidiobolomycosis can cause intussusception. This report will inform clinicians of the importance of considering gastrointestinal basidiobolomycosis in the differential diagnosis of chronic abdominal pain in children, even in the absence of fever or a clinically obvious abdominal mass, especially in countries such as Saudi Arabia, where cases have been reported.
... Basidiobolomycosis is an unusual fungal infection caused by Basidiobolus ranarum [1]. This saprophytic fungal infection originates from the zygomycetes family, often involving sites such as skin and subcutaneous tissues [2,3]. ...
Basidiobolomycosis is a rare fungal infection caused by saprophyte Basidiobolus ranarum. It is rarely seen in healthy adult patients; however, it usually affects children. The commonly involved sites are skin and subcutaneous tissue, mostly found in the Middle East and the southwestern United States. The diagnosis is challenging because of the lack of specific clinical presentation and the absence of predisposing factors.
In our case report, we discuss a 38-year-old male patient who presented with a 2-months history of right lower quadrant pain. Initially, his pain was intermittent and gradually increased in intensity; it localized to the right lower quadrant and radiated to the right flank region. No relieving or aggravating factors were noted. In addition, the patient mentioned a history of constipation, weight loss, decreased appetite, and vomiting-however, no history of fever, night sweats, trauma, or recent travel. The diagnosis was made based on computerized tomography (CT) guided biopsy of the mass, illustrating the findings of fungal hyphae with a gradual increase in the eosinophilic count since admission. The patient was managed using a combined medical and surgical approach, including surgical debulking of the mass and a well-monitored course of anti-fungal therapy.
Gastrointestinal basidiobolomycosis infection (GBI) can present in many forms, with an increasing potential to invade the colon, ultimately forming an inflamed mass. Nonetheless, the presence of a mass invading the colon, adjacent vessels, and a retroperitoneal area, along with an increase in the number of eosinophil count in the Middle East region, should raise the suspicion of basidiobolomycosis fungal infection.
... (Feio et al., 1999;Maniania et al., 2008). Cutaneous lesions in amphibians, subcutaneous infection in horses, and gastrointestinal lesions in dogs have so far been reported (Carmo et al., 2020;Gugnani, 1999;Khan et al., 2001;Nazir et al., 1997). The digestive tracts of various amphibians and reptiles have been found to harbor members of the family Basidiobolaceae. ...
... Similarly, antigenic analysis, isoenzyme banding and restriction enzyme analysis show that all human pathogens belong to B. ranarum. In two studies, B. ranarum was isolated in South India (Khan et al., 2001;Patro et al., 2019). Many articles have specified that the house gecko had a role in the epidemiology of salmonellosis and had an impact on public health (Jimenez et al., 2015). ...
... Substratum: Fish (Nickerson & Hutchison 1971); Amphibians (frogs, toads) (Coremans-Pelseneer 1973); house gecko faeces (Hemiolactylus sp.) (Claussen & Schmidt 2019); wall gecko (Hemiolactylus sp.) (Gugnani & Okafor 1980); bat (Chaturvedi et al. 1984); child/adult, human (Khan et al. 2001, Yusuf et al. 2003; dead Asian House Gecko (Hemiolactylus sp.) (this study). ...
... Distribution: Arkansas and Missouri, American (Nickerson & Hutchison 1971); Kinshasa, Zaire (Coremans-Pelseneer 1973); Nsukka, Nigeria (Gugnani & Okafor 1980); India (Chaturvedi et al. 1984, Khan et al. 2001; Jizan, Saudi Arabia (Yusuf et al. 2003 Notes: Our isolate KUMCC 21-0467 shares similar characteristics with Basidiobolus magnus and B. ranarum in having globose to subglobose, smooth, thick-walled zygospore 20-60 μm in diameter, wrapped in mycelium, with a conjugation beak (Eidam 1886, Davis et al. 1994. The BLASTn results show the ITS gene region highly overlaps with B. magnus (ARSEF 1139) at 99.3% (668/673 bp, 0 gap), at 99% (664/672 bp, 0 gap) similarity with B. ranarum (ARSEF 260), and the LSU region indicates 99.8 % similarity (1010/1012bp, 0 gap) with B. ranarum (ARSEF 8303) and B. magnus (CBS 205.64). ...
A dead Asian House Gecko, infected with multiple species of fungi, was found floating in a jug of water inside a building in Kunming, China. The dead gecko was taken to the mycology laboratory at the Kunming Institute of Botany, Chinese Academy of Sciences and different fungal species were isolated. Phylogenetic analyses were carried out on the resultant isolates based on multiple gene sequences (ITS, LSU, mtSSU, rpb1, rpb2, tub2, Bloc, CAL, CHS-1, GAPDH, tef1-α). In addition to the phylogenetic analyses, morphological characteristics were also used to describe the fungal taxa. The entomopathogenic fungus Basidiobolus ranarum was isolated from the gecko’s inflamed right forelimb, while Beauveria bassiana was isolated from the gecko’s forehead. In addition, the neck skin yielded a common and important plant pathogen Colletotrichum jianxiense. Full descriptions, color plates of macro and micro structures of fungal taxa, and phylogenetic trees to show the placements of fungal taxa are provided. These findings represent either new host records or new country records for the three fungal species.
... It usually causes slowly progressive subcutaneous infection. Gastrointestinal basidiobolomycosis may mimic inflammatory bowel disease, malignancies, appendicitis, and diverticulitis [2]. ...
... Gastrointestinal basidiobolomycosis may mimic inflammatory bowel disease, malignancies, hydatid cyst, hepatic abscess, appendicitis, and diverticulitis [2]. In this case, hepatic basidiomycosis was reported in an immunocompetent 12-year-old female from the south of Iran with a tropical climate (Hormozgan Province). ...
Basidiobolomycosis is a rare invasive fungal infection, usually causing subcutaneous infection. Medical literature has rarely reported gastrointestinal and disseminated infections. We report a case of hepatic basidiobolomycosis in an immunocompetent 12-year-old girl from Iran who presented with fever, abdominal pain, and loss of appetite. She had a history of abdominal trauma two months prior. We found a mass in the left lobe of the liver; thus, an ultrasound- guided biopsy was performed. Basidiobolomycosis was diagnosed through pathological findings. Accordingly, a prolonged course of antifungal agents was prescribed, and the patient’s symptoms improved.
Gastrointestinal basidiobolomycosis is a rare fungal infection that rarely only affects the liver. Clinical manifestations may mimic malignant tumors, hepatic abscess, hepatic cyst, inflammatory bowel disease, or even the phlegmon of appendicitis. In tropical regions, fungal infections like basidiobolomycosis should be considered through differential diagnosis. Usually, long-term antifungal therapy and surgical resection are required. If diagnosed late, the disease presents a high mortality rate. However, our patient was diagnosed and treated early; therefore, she could recover.
