Gastrointestinal basidiobolomycosis in a child; an unusual fungal infection mimicking fistulising Crohn's disease Omar I. Saadah, Mohammad F. Farouq,

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Presentation transcript:

Gastrointestinal basidiobolomycosis in a child; an unusual fungal infection mimicking fistulising Crohn's disease Omar I. Saadah, Mohammad F. Farouq, Nawaf Al Daajani, Jamal S. Kamal, Ahmad T. Ghanem Journal of Crohn's and Colitis Volume 6, Issue 3, Pages 368-372 (April 2012) DOI: 10.1016/j.crohns.2011.10.008 Copyright © 2011 European Crohn's and Colitis Organisation Terms and Conditions

Figure 1 Severely inflamed colonic mucosa covered with exudates with cobble stoning of the mucosa and deep ulcers. Journal of Crohn's and Colitis 2012 6, 368-372DOI: (10.1016/j.crohns.2011.10.008) Copyright © 2011 European Crohn's and Colitis Organisation Terms and Conditions

Figure 2 CT scan of the abdomen with contrast showed wall thickening of distal ileal loop (the large arrow) and large inflammatory mass (the small arrow). Journal of Crohn's and Colitis 2012 6, 368-372DOI: (10.1016/j.crohns.2011.10.008) Copyright © 2011 European Crohn's and Colitis Organisation Terms and Conditions

Figure 3 Histopathological features seen in this patient. A. A well defined granuloma (blue arrow) rich in foreign body giant cells in the muscle layer of the intestine close to a fistula (H&E,×10). B. Extensive necrosis of the muscle layer of the colon showing a giant cell, fungal spore (red arrow) and neutrophilic infiltrate (H&E, ×20). C. PAS positive large spores and hyphae of the fungus. Splendore-Hoeppli phenomenon (green arrow) in the form of the eosinophilic sheath around the spores of the fungus. (PAS, ×40). D. Spores and hyphae of the zygomycetes (pink arrow) positive for the fungus stain (Methenamine silver, ×40). Journal of Crohn's and Colitis 2012 6, 368-372DOI: (10.1016/j.crohns.2011.10.008) Copyright © 2011 European Crohn's and Colitis Organisation Terms and Conditions

Figure 4 Contrast study with gastrograffin through ileostomy showed ileo-vesical fistula. Journal of Crohn's and Colitis 2012 6, 368-372DOI: (10.1016/j.crohns.2011.10.008) Copyright © 2011 European Crohn's and Colitis Organisation Terms and Conditions

Figure 5 Normal colonic mucosa following 12months of antifungal therapy. Journal of Crohn's and Colitis 2012 6, 368-372DOI: (10.1016/j.crohns.2011.10.008) Copyright © 2011 European Crohn's and Colitis Organisation Terms and Conditions