A Case of Subcutaneous and Gastrointestinal Basidiobolomycosis in Singapore

Öz Entomophthoromycosisdue to Basidiobolus is a known cause of subcutaneous zygomycosis. Itoccasionally causes invasive disease involving the gastrointestinal tract. Wedescribe a case of proven subcutaneous entomophthoromycosis, with subsequentdevelopment of gastrointestinal basidiobolomycosis, in a 67 year oldSingaporean Chinese male. He presented with a progressively enlarging leftinguinal mass with intra-abdominal extension, causing compression of the uretersand hydronephroses. He underwent multiple biopsies to ascertain the cause ofthe mass. Workup for malignancy, bacteria, fungal, parasitic and tuberculousinfections were negative.  He developedworsening gastrointestinal distension a year from initial presentation. Imagingshowed mucosal thickening extending from the descending colon to the rectum.Based on the clinical presentation, he was treated as for basidiobolomycosis.He responded poorly to treatment and passed away two months after initiation oftherapy. With the help of our counterparts in India, we proved our clinicalsuspicion by polymerase chain reaction on tissue specimen. 

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