Basidiobolomycosis is a fungal disease caused by '' Basidiobolus ranarum''. It may appear as one or more painless firm

nodules Nodule may refer to: *Nodule (geology), a small rock or mineral cluster *Manganese nodule, a metallic concretion found on the seafloor *Nodule (medicine), a small aggregation of cells *Root nodule Root nodules are found on the roots of plants, p ...

in the skin which becomes purplish with an edge that appears to be slowly growing outwards. A serious but less common type affects the stomach and intestine, which usually presents with tummy ache, fever and a

lump Lump may refer to: * "Lump" (song), a 1995 song by The Presidents of the United States of America * ''Lump'' (compilation album), a 2000 best-of album by The Presidents of the United States of America * Lump (dog), a dog who inspired Pablo Pic ...

. ''B. ranarum'', can be found in soil, decaying vegetables and has been isolated from insects, some reptiles, amphibians, and mammals. The disease results from direct entry of the fungus through broken skin such as an insect bite or trauma, or eating contaminated food. It generally affects people who are well. Diagnosis is by

medical imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to rev ...

biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a diseas ...

microscopy Microscopy is the technical field of using microscopes to view objects and areas of objects that cannot be seen with the naked eye (objects that are not within the resolution range of the normal eye). There are three well-known branches of micr ...

, culture and histopathology. Treatment usually involves

amphotericin B Amphotericin B is an antifungal medication used for serious fungal infections and leishmaniasis. The fungal infections it is used to treat include mucormycosis, aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, and cryptococcosis. Fo ...

and surgery. Although ''B. ranarum'' is found around the world, the disease Basidiobolomycosis is generally reported in

tropical The tropics are the regions of Earth surrounding the Equator. They are defined in latitude by the Tropic of Cancer in the Northern Hemisphere at N and the Tropic of Capricorn in the Southern Hemisphere at S. The tropics are also referred to ...

and

subtropical The subtropical zones or subtropics are geographical zone, geographical and Köppen climate classification, climate zones to the Northern Hemisphere, north and Southern Hemisphere, south of the tropics. Geographically part of the Geographical z ...

areas of Africa, South America, Asia and

Southwestern United States The Southwestern United States, also known as the American Southwest or simply the Southwest, is a geographic and cultural region of the United States that generally includes Arizona, New Mexico, and adjacent portions of California, Colorado, Ne ...

. It is rare. The first case in a human was reported from Indonesia as a skin infection in 1956.

Signs and symptoms

Basidiobolomycosis may appear as a firm nodule in the skin which becomes purplish with an edge that appears to be slowly growing outwards. It is generally painless but may feel itchy or burning. There can be one lesion or several, and usually on the arms or legs of children. Pus may be present if a bacterial infection also occurs. The infection can spread to nearby structures such as muscles, bones and lymph nodes. A serious but less common type affects the stomach and intestine, which usually presents with tummy ache, fever and a

. Lymphoedema may occur.

Mechanism

Basidiobolomycosis is a type of Entomophthoromycosis, the other being conidiobolomycosis, and is caused by '' Basidiobolus ranarum'', a fungus belonging to the order Entomophthorales. ''B. ranarum'' has been found in soil, decaying vegetables and has been isolated from insects some reptiles, amphibians, and mammals. The disease results from direct entry of the fungus through broken skin such as an insect bite or trauma, or eating contaminated food. Diabetes may be a risk factor. The exact way in which infection results is not completely understood.

Diagnosis

Diagnosis is by

culture Culture () is an umbrella term which encompasses the social behavior, institutions, and norms found in human societies, as well as the knowledge, beliefs, arts, laws, customs, capabilities, and habits of the individuals in these groups.Tyl ...

and

. A review in 2015 showed that the most common finding on imaging of the abdomen was a mass in the bowel, the liver, or multiple sites and bowel wall thickening. Initially, many were considered to have either a cancer of the bowel or Crohns disease.

Treatment

Treatment usually involves itraconazole or

, combined with

surgical debridement Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. Removal may be surgical, mechanical, chemical, autolytic (self-digestion), and by maggot therapy. In po ...

. Bowel involvement may be better treated with

voriconazole Voriconazole, sold under the brand name Vfend among others, is an antifungal medication used to treat a number of fungal infections. This includes aspergillosis, candidiasis, coccidioidomycosis, histoplasmosis, penicilliosis, and infections by '' ...

Epidemiology

The condition is rare but emerging. Men and children are affected more than females. The disease is generally reported in

and

areas of Africa, South America, Asia and several cases in

History

The first case in a human was reported from Indonesia as a skin infection in 1956. In 1964, the first case involving stomach and intestine was reported.

Society and culture

Cases among gardeners in Arizona, US, may indicate an occupational hazard, but is unproven.