Dramatic Response of Gastric Outlet Obstruction with Ileoceccal Involvement of Basidiobolomycosis to Amphotericin B: A Case Report
Author(s): Mehrdad Sayadinia, Ali AtashAbParvar, Bahram Nateghi
Gastrointestinal Basidiobolomycosis (GIB) is a fungal infection in the stomach, small intestine, colon, and liver that can play a role in malignancy. It is a rare disease and only about 73 cases of GIB exist in the literature. Abdominal pain, weight loss, fever and abdominal mass are the most common symptoms which are clues of definitive diagnosis by microbial culture from surgical specimens. In present article, we have reported a case of GIB with gastric outlet obstruction that dramatically has responded to treatment of Amphotericin B. A 44 y/o male was admitted by chief complaint of early post meal vomiting and dyspepsia. He also had a noticeable weight loss in the last 6 months. There were not any other sign or symptoms as fever or etc. However, two masses were observed by abdominopelvic contrasted CT scan; one in second portions of duodenum and the other one in ceccum. Therefore, he was planned for surgery and a jejunustomy tube was placed for the elimination and operation was terminated because the lack of definite diagnosis. Final results of pathology confirmed the fungal infection compatible with basidiobolumycosis. After the 3rd day of laparatomy diet and Intravenous Amphotircin B were started for the patient. After 2 weeks of start of amphotricin B patient scheduled for second laparatomy for permanent gasterojejunostmy. Finally, in the next follow up in 3 months patient was completely relieved of all sign and symptoms. A Contrasted abdomen and pelvic CT scan was performed with any signs of previous masses. In conclusion, surgery could be avoidable by early diagnosis and treatment of GIB by administration of Intravenous Amphotircin B.