Subcutaneous Basidiobolomycosis in an Immunocompetent Child: A Case Report ED01-ED02
Dr. Aruna Chhikara,
Department of Pathology, Lady Hardinge Medical College, New Delhi-110001, India.
Basidiobolus ranarum is a fungus belonging to Basidiobolus genera, Entomophthorales order and Zygomycetes class. It is present in soil, decaying vegetable matter, intestines of amphibians, reptiles, fish and insectivorous bats. In humans, it presents generally as a subcutaneous infection involving trunk and limbs in immunocompetent hosts from endemic areas. We present a case of a two-year-old male who presented with two hard subcutaneous swellings since one month. FNAC smears from the swellings showed granulomatous inflammation with many eosinophils. However, no fungal elements were identified. Incisional biopsy was done and on histopathological examination, many fungal hyphae were identified which were broad, thin-walled with sparse septations which were surrounded by many granulomas along with presence of giant cells, eosinophils, lymphocytes and plasma cells in the subcutis. Splendore-Hoeppli phenomenon was also seen in subcutis. Periodic Acid Schiff (PAS) stain and Silver Methanamine (SM) stain for fungus was positive. Fungal culture was negative. A final diagnosis of basidiobolomycosis was made. Subcutaneous basidiobolomycosis, is an emerging infection that leads to diagnostic confusion, morbidity and mortality. Diagnosis requires a high index of suspicion and awareness of histomorphology of this rare fungal infection.