August
20, 1998 Contact: Media Relations Division (404) 639-3286
Basidiobolomycosis of the gastrointestinal tract is a new or
emerging infection that may have been previously unrecognized. Cases of
gastrointestinal basidiobolomycosis are often misdiagnosed as cancer and
inflammatory bowel disease.
Basidiobolomycosis of the gastrointestinal tract is very rare in
people. Only 6 cases have been described in the world's medical
literature. Those cases were reported from Brazil (3), Kuwait (1), and
the United States (2). Half of the case-patients died despite medical
therapy.
Basidiobolomycosis of the gastrointestinal tract usually begins with
pain, and sometimes a mass can be felt in the abdomen. Treatment is not
standardized, but should include itraconazole or ketoconazole possibly
with surgical removal of the mass.
A more common form of basidiobolomycosis causes chronic,
subcutaneous, fungal infection that usually affects people and some
animals (such as horses and dogs). The name of the specific fungus is
Basidiobolus ranarum.
The fungus is found mainly in the soil and on decaying vegetation.
It has also been isolated from the river banks of tropical rivers in
West Africa, and has also been found in association with some insects.
The fungus is known to be present in the gastrointestinal tracts of
reptiles, amphibians, and some bat species.
Subcutaneous disease is found most commonly among adolescent males
in East and West Africa and Southeast Asia. The mechanism of
transmission is thought to be traumatic inoculation.
The disease usually starts as a painless nodule or "lump" underneath
the skin on the trunk or limbs. The nodule grows slowly and can become
large and disfiguring. Sometimes the nodules can block the lymphatic
drainage from the limb causing swelling or elephantiasis.
Several medicines have been successfully used to treat
basidiobolomycosis; these include: itraconazole, ketoconazole,
co-trimoxazole, and potassium chloride. All of these medications are
given by mouth, but they require many months of treatment. Treatment
usually continues for at least 1 month after the lesions disappear.
