Overview
Disseminated basidiobolomycosis is a rare, chronic fungal infection caused by Basidiobolus species, typically affecting the skin and subcutaneous tissues, but capable of disseminating to other organs. It often presents with ulcerative skin lesions and can be challenging to treat, especially in immunocompromised individuals 1.Diagnosis
Clinical presentation includes chronic, progressive skin lesions, often ulcerative and suppurative 1.
Histopathological examination is crucial, showing fungal hyphae consistent with Basidiobolus species 1.
Culture of tissue samples from lesions is definitive for diagnosis 1.
Imaging may show soft tissue involvement but is not diagnostic on its own 1.Management
First-line treatment: Surgical debridement of necrotic tissue combined with antifungal therapy 1.
Antifungal agents: Itraconazole is commonly used, often at doses tailored to the severity and extent of infection 1.
Adjunctive therapies: Supportive care including wound management and addressing underlying comorbidities 1.
Palliative procedures: In cases with severe complications like ischemia, surgical bypass procedures may be considered for symptom relief 1.Special Populations
Comorbidities: Patients with significant comorbidities such as renal failure or severe cardiopulmonary disease may require tailored approaches focusing on symptom management and palliative care 1.
No specific data: Limited information on pregnancy, pediatrics, or elderly populations in the provided abstracts 1.Key Recommendations
Surgical debridement followed by antifungal therapy is essential for managing disseminated basidiobolomycosis (Evidence: Moderate 1).
Consider palliative surgical interventions like exclusion bypass for severe complications in high-risk patients (Evidence: Weak 1).
Tailor treatment to underlying comorbidities, focusing on supportive care and symptom management in complex cases (Evidence: Expert opinion 1).References
1 Kaufman JL, Saifi J, Chang BB, Shah DM, Leather RP. The role of extraanatomic exclusion bypass in the treatment of disseminated atheroembolism syndrome. Annals of vascular surgery 1990. link