1/9. Basidiobolus ranarum as an etiologic agent of gastrointestinal zygomycosis.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; its clinical presentation is nonspecific, there are no identifiable risk factors, and all age groups are susceptible. The case of gastrointestinal basidiobolomycosis described in the present report occurred in a 41-year-old Indian male who had a history of repair of a left inguinal hernia 2 years earlier and who is native to the southern part of india, where the subcutaneous form of the disease is indigenous. diagnosis is based on the isolation of B. ranarum from cultures of urine and demonstration of broad, sparsely septate hyphal elements in histopathologic sections of the colon, with characteristic eosinophilic infiltration and the Splendore-Hoeppli phenomenon. The titers of both immunoglobulin g (IgG) and IgM antibodies to locally produced antigen of the fungus were elevated. The patient failed to respond to 8 weeks of amphotericin b therapy, and the isolate was later found to be resistant to amphotericin b, itraconazole, fluconazole, and flucytosine but susceptible to ketoconazole and miconazole. One other noteworthy feature of the fungus was that the patient's serum showed raised levels of Th2-type cytokines (interleukins 4 and 10) and tumor necrosis factor alpha. The present report underscores the need to consider gastrointestinal basidiobolomycosis in the differential diagnosis of inflammatory bowel diseases and suggests that, perhaps, more time should be invested in developing standardized serologic reagents that can be used as part of a less invasive means of diagnosis of the disease.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
2/9. Transient fungemia due to rhodotorula rubra in a cancer patient: case report and review of the literature.A unique case of rhodotorula rubra transient fungemia in a post-chemotherapy, febrile neutropenic patient with colon cancer, suffering from gastrointestinal mucositis, is described. The fungus was isolated repeatedly from his blood. However, all signs and symptoms of the infection disappeared, without antifungal treatment, as soon as neutropenia and mucositis, both of short duration, resolved. Restoration of the patient's defense mechanisms was adequate for disappearance of the fungus from the patient's blood and full recovery.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
3/9. lung infection due to opportunistic fungus, Phialemonium obovatum, in a bone marrow transplant recipient: an emerging infection with fungemia and crohn disease-like involvement of the gastrointestinal tract.We report the first case of Phialemonium obovatum fungemia with subsequent caseating granulomatas in the lung and crohn disease-like involvement of the gastrointestinal tract in a bone marrow transplant recipient. This phaeoid fungus has been rarely described as an opportunistic infection in immunosuppressed patients. The patient was diagnosed with chronic myelogenous leukemia and underwent subsequent peripheral bone marrow transplant. After 6 months, he developed graft-versus-host disease of the skin and liver with fever and severe diarrhea. Fecal bacterial cultures and cytomegalovirus serologies were negative. Computed tomographic scan showed a peripheral pulmonary mass. A lung wedge biopsy of the lesion showed septate branching hyphae (4-5 microm in diameter) with terminal globular structures (10 microm in diameter). The hyphae were similar in width to that of an aspergillus species but had a more moniliform appearance. Blood cultures grew a pure culture of P. obovatum. He was treated with amphotericin b and itraconazole for 6 months without remission of the diarrhea. Biopsies of the stomach, colon, and rectum showed granulomatous inflammation with marked crypt distortion simulating crohn disease. In retrospect, the fungus was found to be resistant to both of the aforementioned drugs and susceptible to voriconazole and posaconazole. The gastrointestinal findings raise the possibility of further dissemination of a partially treated Phialemonium infection.- - - - - - - - - - ranking = 3keywords = fungus (Clic here for more details about this article) |
4/9. Gastrointestinal, hepatic, and pancreatic involvement with cryptococcus neoformans in AIDS.We describe three cases of acquired immunodeficiency syndrome (AIDS) complicated by disseminated cryptococcosis with gastrointestinal involvement. The stomach, duodenum, colon, pancreas, and liver showed invasion by the fungus. Although none of the patients had any symptoms attributable to cryptococcus neoformans, we speculate that cryptococcal invasion of the liver and gastrointestinal tract may be a contributor to the morbidity in these immunocompromised patients.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
5/9. Gastrointestinal dissemination of coccidioidomycosis.An unusual case of extensive gastrointestinal involvement by the fungus coccidioides immitis is reported in a 21-yr-old man. This unique case demonstrates the occurrence of this fungus within chylous ascites, the mesentery, and invasion of the entire length of the small bowel. Histological and cultural documentation for gastrointestinal tract involvement by C. immitis other than for the rare occurrence of peritonitis has not been previously reported. The significance of the disseminated gastrointestinal coccidioidomycosis in the setting of chylous ascites and extensive abdominal lymphatic involvement is discussed with respect to its pathogenesis and treatment.- - - - - - - - - - ranking = 1keywords = fungus (Clic here for more details about this article) |
6/9. Malabsorption syndrome occurring in the course of disseminated histoplasmosis: case report and review of gastrointestinal histoplasmosis.histoplasmosis is caused by the dimorphic fungus, histoplasma capsulatum. The disease spectrum varies from a mild respiratory infection to a lethal, disseminated form. Involvement of any part of the gastrointestinal tract may occur with the disseminated form, and symptoms reflect that portion involved. A case of malabsorption syndrome occurring during the course of disseminated histoplasmosis is reported, and the literature of gastrointestinal histoplasmosis is reviewed.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
7/9. Gastrointestinal entomophthoramycosis caused by Basidiobolus haptosporus.There was described the first cultural proven case of gastrointestinal entomophthoramycosis caused by B. haptosporus. A review of the literature on gastrointestinal zygomycosis led us to presume that similar clinical reported cases have been also caused by this fungus. A commentary on the designation of the clinical forms of the infections caused by Zygomycetes was also made.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
8/9. Gastrointestinal mucormycosis causing an acute abdomen in the immunocompromised pediatric patient--three cases.mucormycosis is an infection caused by a ubiquitous fungus in immunocompromised individuals. Typically, it invades blood vessels, producing thrombosis and tissue infarction. This infection spans all pediatric age groups and can lead to hollow viscus perforation and bowel obstruction. A 30-month old male with large cell anaplastic lymphoma had a bowel obstruction. During emergency laparotomy, an ileoileal intussusception was identified, which required resection and anastomosis. In the pathological specimen, fungi of the mucorales order were found to be associated with tissue necrosis. On the eighth day of life, a premature infant had abdominal distension secondary to bowel perforation. Partial gastric resection and multiple intestinal stomas were performed. death occurred soon after, secondary to multiorgan failure. The autopsy and surgical specimens showed widespread mucormycosis. An adolescent had meningococcemia-induced septic shock. During recovery, hemorrhagic colitis developed, which led to perforation. The subtotal colectomy specimen showed widespread mucormycosis. The laparotomy findings are typical (black necrotic tissue involving the bowel), and when seen in the immunocompromised patient, should make one suspect gastrointestinal mucormycosis. Aggressive surgical debridement of devitalized tissue augmented by intravenous antifungal medication is the mainstay of treatment.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |
9/9. Gastrointestinal histoplasmosis in a patient with acquired immune deficiency syndrome.In otherwise healthy individuals, disease caused by the fungus histoplasma capsulatum manifests itself as a self-limiting pulmonary infection. Dissemination of the organisms may occur in a setting of compromised cellular immunity. Gastrointestinal involvement occurs in many such cases, but rarely it is clinically obvious and the disease seldom comes to the attention of the general surgeon. However, with the increasing incidence of acquired immunodeficiency syndromes, general surgeons are managing more of these patients than in the past. In our report, we describe a patient with acquired immunodeficiency syndrome who presented with gastrointestinal histoplasmosis.- - - - - - - - - - ranking = 0.5keywords = fungus (Clic here for more details about this article) |