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Emerging fungal infection in South West U.S. mimics cancer
- March 29, 2012
- Mayo Clinic
- An emerging fungal infection mimics cancer and IBD, accorading to medical researchers. Fungus, found in soil and GI tracts of fish, reptiles, amphibians and bats, appears to cause basidiobolomycosis. 44 cases around the world were studied, 17 from Arizona. Symptoms can be abdominal pain or a mass that mimics abdominal cancer. Early detection is key.
The invasive fungus, Basidiobolus ranarum, is typically found in the soil, decaying organic matter and the gastrointestinal tracts of fish, reptiles, amphibians, and bats.
(a) Colonic Basidiobolus ranarum appearing as broad, septate hyphae surrounded by an eosinophilic sheath (Splendore–Hoeppli phenomenon) and numerous eosinophils.
(b) Broad fungal hyphae of B. ranarum (periodic acid–Schiff diastase stain).
(c) Multinucleated giant cells phagocytosing fungal zygospores. The latter appear as spherical bodies that measure up to 30 m m in diameter. They have a thin outer wall, foamy cytoplasm, and a nucleus containing a large nucleolus (haematoxylin and eosin stain).
(d) Broad, septate fungal hyphae (black; Grimelius methenamine silver stain).
Basidiobolus ranarum is a filamentous fungus with worldwide distribution.[1]
The fungus was first isolated by Eidam in 1886. It can saprophytically live in the intestines of mainly cold-blooded vertebrates and on decaying fruits and soil.
The fungus prefers glucose as a carbon source and grows rapidly at room temperature.
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Fungal mycelium
Microscopic view of a mycelium. This image covers a one-millimeter
At room temperature (25–30 °C), colonies of B. ranarum show very rapid growth and are able to reach a diameter of 75–80 mm in a week on suitable growth media.[2] The favored carbohydrate source of this fungus is glucose that can stimulate the growth of its mycelium.[13] Generally, asexual reproduction is favored by glucose and sexual reproduction is favored by acid amines.[14] Primary asexual spores are singly formed on the apices of unbranched hyphae and will then be discharged to form ballistic spores.[15] Secondary asexual spores are singly developed from a hypha that was generated from a geminated ballistic spore.[1][15] Also, sporangiospores can be generated by internal cleave of the cytoplasm and can then be dispersed when the sporangial wall is dissolved. As a result, the ejected asexual spores can form satellite colonies in a distance. After around 10 days of growth, sexual spores, zygospores with 20–50 μm diameters can also be produced.[16] This fungus is believed to have significant protease and lipase activity.[17][18] Its lipase has a maximum activity at 35 °C and pH 6.0[18] while its protease has maximum activity at 30 °C and pH 5.5.[17] Both enzymes might be involved in pathogenesis.[17][18] - https://en.wikipedia.org/wiki/Mycelium
Microscopic view of a mycelium. This image covers a one-millimeter
Mayo researchers studied 44 cases of human gastrointestinal basidiobolomycosis reported from around the world, including 17 from Arizona, one from southern Utah and one from elsewhere in the U.S. Eight of the 44 patients died. Mayo's review of the cases is published online in the journal Clinical Infectious Diseases.
Basidiobolomycosis is usually a subcutaneous infection in the tropical and subtropical regions of the world that develops following traumatic inoculation of the fungus under the skin. The emergence of gastrointestinal involvement with Basidiobolus in arid regions has been considered unusual.
"The exact mode of acquisition of this gastrointestinal infection is unclear, although consumption of contaminated food or dirt is the favored hypothesis," says lead author H.R. Vikram, M.D., an infectious diseases physician at Mayo Clinic, where seven of the 19 U.S. cases studied were treated. "The infection is still considered so rare that no one had put together a complete description." He adds that more study needs to be done to determine how this infection is contracted, what underlying diseases might predispose patients to this infection and how best to treat it. He emphasizes that early recognition is key to successful treatment.
The first U.S. case of gastrointestinal Basidiobolus infection was reported in 1986. The CDC subsequently investigated six cases in Arizona between 1994 and 1999. This sparked the interest of researchers at Mayo Clinic in Arizona to study this infection.
Patients with this rare fungal infection had non-specific symptoms such as abdominal pain or a mass that could be felt on examination. Before a conclusive diagnosis of the fungal infection was made, most patients were thought to have an abdominal cancer, inflammatory bowel disease or diverticulitis. Surgical resection of the area of involvement and prolonged antifungal therapy successfully treated most patients.
Study co-authors include Jerry Smilack, M.D., retired; Infectious Diseases; Jonathan Leighton, M.D., and Michael Crowell, Ph.D., Gastroenterology; and Giovanni De Petris, M.D., Anatomic Pathology.
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Mayo Clinic Reports Emerging Fungal Infection in Southwest That Mimics Cancer
March 29, 2012
PHOENIX — March 29, 2012. An emerging fungal infection of the gastrointestinal tract that mimics cancer and inflammatory bowel disease appears to be emerging in the Southwestern United States and other desert regions, according to Mayo Clinic researchers in Arizona investigating the disease. The invasive fungus, Basidiobolus ranarum, is typically found in the soil, decaying organic matter and the gastrointestinal tracts of fish, reptiles, amphibians, and bats.
Holenarasipur (HR) R. Vikram, M.D., infectious disease specialist at Mayo Clinic in Arizona, discusses how gastrointestinal basidiobolomycosis is an emerging invasive fungal infection in desert regions of the US Southwest. The clinical findings of this infection mimic malignancy and inflammatory bowel disease.
Mayo researchers studied 44 cases of human gastrointestinal basidiobolomycosis reported from around the world, including 17 from Arizona, one from southern Utah and one from elsewhere in the U.S. Eight of the 44 patients died. Mayo's review of the cases is published online in the journal Clinical Infectious Diseases.
Basidiobolomycosis is usually a subcutaneous infection in the tropical and subtropical regions of the world that develops following traumatic inoculation of the fungus under the skin. The emergence of gastrointestinal involvement with Basidiobolus in arid regions has been considered unusual.
"The exact mode of acquisition of this gastrointestinal infection is unclear, although consumption of contaminated food or dirt is the favored hypothesis," says lead author
H.R. Vikram, M.D., an infectious diseases physician at Mayo Clinic, where seven of the 19 U.S. cases studied were treated. "The infection is still considered so rare that no one had put together a complete description." He adds that more study needs to be done to determine how this infection is contracted, what underlying diseases might predispose patients to this infection and how best to treat it. He emphasizes that early recognition is key to successful treatment.
H.R. Vikram, M.D., an infectious diseases physician at Mayo Clinic, where seven of the 19 U.S. cases studied were treated. "The infection is still considered so rare that no one had put together a complete description." He adds that more study needs to be done to determine how this infection is contracted, what underlying diseases might predispose patients to this infection and how best to treat it. He emphasizes that early recognition is key to successful treatment.
The first U.S. case of gastrointestinal Basidiobolus infection was reported in 1986. The CDC subsequently investigated six cases in Arizona between 1994 and 1999. This sparked the interest of researchers at Mayo Clinic in Arizona to study this infection.
Patients with this rare fungal infection had non-specific symptoms such as abdominal pain or a mass that could be felt on examination. Before a conclusive diagnosis of the fungal infection was made, most patients were thought to have an abdominal cancer, inflammatory bowel disease or diverticulitis. Surgical resection of the area of involvement and prolonged antifungal therapy successfully treated most patients.
Study co-authors include Jerry Smilack, M.D., retired; Infectious Diseases; Jonathan Leighton, M.D., and Michael Crowell, Ph.D., Gastroenterology; and Giovanni De Petris, M.D., Anatomic Pathology.
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-reports-emerging-fungal-infection-in-southwest-that-mimics-cancer/
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-reports-emerging-fungal-infection-in-southwest-that-mimics-cancer/
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Journal Reference:
- H. R. Vikram, J. D. Smilack, J. A. Leighton, M. D. Crowell, G. De Petris. Emergence of Gastrointestinal Basidiobolomycosis in the United States, With a Review of Worldwide Cases. Clinical Infectious Diseases, 2012; DOI: 10.1093/cid/cis250
Fungal infection has become one of the most spreaded infection all over the world. I too was suffering from the same. Thanks to author who had suggested theremedy for such disease so well. It is helpful.
VastaaPoistaGreat work and great information about skin .
VastaaPoista