Gastro-intestinal basidiobolomycosis in a 2-year-old boy: dramatic response to potassium iodide

Paediatr Int Child Health. 2018 May;38(2):150-153. doi: 10.1080/20469047.2016.1186343. Epub 2016 Jul 4.

Abstract

Gastro-intestinal basidiobolomycosis (GIB) is a rare fungal infection caused by Basidiobolus ranarum. Treatment includes surgical resection and long-term antifungal therapy. A 2.5-year-old boy presented with a 10-day history of abdominal pain, fever and diarrhoea, and a palpable abdominal mass was detected. Resection was undertaken and histology confirmed basidiobolomycosis. Treatment with amphotericin B and itraconazole was commenced, but the infection progressed and spread to involve the intestines, liver, ribs and lung, and also the abdominal wall after 6 months, requiring four operative procedures. Because of unresponsiveness to amphotericin and itraconazole, oral potassium iodide was added which resulted in complete resolution of the infection. Potassium iodide is an essential component of the treatment of systemic B. ranarum.

Keywords: Amphotericin B; Fungal infection; Gastro-intestinal basidiobolomycosis; Itraconazole; Potassium iodide.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / administration & dosage*
  • Child, Preschool
  • Entomophthorales / isolation & purification*
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / microbiology
  • Gastrointestinal Diseases / pathology
  • Gastrointestinal Diseases / therapy*
  • Histocytochemistry
  • Humans
  • Male
  • Potassium Iodide / administration & dosage*
  • Radiography, Abdominal
  • Radiography, Thoracic
  • Surgical Procedures, Operative
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Zygomycosis / diagnosis*
  • Zygomycosis / microbiology
  • Zygomycosis / pathology
  • Zygomycosis / therapy*

Substances

  • Antifungal Agents
  • Potassium Iodide