1. The Royal hospital experience
Gastrointestinal Basidiobolomycosis, an emerging fungal infection of the gastrointestinal tract,
The Royal hospital experience
Mohammed al-Masqari, Fatma Al-Lawti , Amal Al-Maani
Introduction
Materials and Methods
Results
Conclusion
Basidiobolomycosis is a rare disease caused by the fungus Basidobolus ranarum, an environmental saprophyte found world wide .It is well known that this infection is manifested with skin disease and rarely involve the gastrointestinal tract. Gastrointestinal Basidobolus mycosis poses diagnostic difficulties, as it is clinical presentation is not specific and can mimic other serious diseases like malignancy. Lack of awareness of GIB has resulted in its delayed diagnosis and in extensive morbidity and mortality in patients with GIB.
In this case series we are retrospectively reviewed 5 cases diagnosed in the Royal hospital 2008 to It will be the largest reported series in patient with GIB in Oman.
The cases are identified by reviewing medical records through Al-Shifa system. In order to ensure that all cases are included, patients diagnosed with any GI fungal infection for the past 8 years are reviewed again by a resident and a consultant pathologist.
The defined cases are confirmed on the bases of the characteristic histolopathologic appearance of broad, thin-walled, pleomorphic hyphae surrounded by a collar of eosinophilic material (known as the Splendore-Hoeppli phenomenon).
Diagnosis of GIB requires high index of suspicion, Increased awareness of this rare disease help reach an early diagnosis and prompt starting treatment. The clinical features of which resemble those of Inflammatory or neoplastic bowel disease. Whenever these diagnoses are entertained, basidiobolomycosis might be considered in the differential diagnosis.
Acknowledgments
The researchers would like to thank the research department at Oman medical specialty board for supervising this research.
Objectives
To examine epidemiology, clinical characteristics, histopathology findings, ancillary techniques which are important for diagnosis, management and outcome of an uncommon manifestation caused by the Basidobolus ranarum.

2. Radiological findings
Demographic
data
Clinical
presentation
Laboratory findings
Radiological findings
Histopathology
Initial Impression
Management
outcome 1
9 year, male
Ad Dakhiliyah
Abdominal pain
mass
vomiting diarrhea
Hypochromic microcystic anemia , leukocytosis, thrombocytosis,
eosinophelia , CRP:205
HIV,neg
Large locualted abscess in the right side of abdomen.
Marked inflammation
Eosinophilic infiltrate
branching Fungal hyphae within pink eosinophilic materials
appendicitis
Mucormycosis
Appendectomy
Labrotomy
Antibiotics
Itraconazole, parentral was not available
Died from :
DIC, Fungal sepsis 2
19 year
Female
fever
vomiting
Cough
Hypochromic microcystic anemia, leukocytosis
thrombocytosis
Eosinophelia ,CRP:196.5
HIV negative
Diffuse gastric, small intestine , large intestine wall thickening
Pneumonia
Caspofungin Ambisome
acyclovir
Died from:
Severe fungal sepsis 3
45 year
Male
Al Dhahirah
abdominal pain
diarrhea
weight loss
Hypochromic microcystic anemia , leukocytosis, thrombocytosis
eosinophelia
CRP:152.6
Diffuse irregular thickening of cecum, ascending colon and transverse colon.
lymphoma
schiostomiasis
fungoma
mucormycosis
Ambisome
Rt hemecolectomy
Severe fungal sepsis 4
5 year
Hypochromic microcystic anemia ,leukocytosis
CRP:199.0
Diffuse irregular thickening of the right side of the colon
GIB (KSA)
Rt hemecolectomy
Voriconazole
Pt clinically improved and discharged home with oral voriconazole
Doing well 5
10 year
Muscat
poor appetite
Hypochromic microcystic anemia
CRP:0.2
Right subhepatic ileocecal mass
obstruction
Basidobolus mycosis
Discharged on voriconazole