Basidiobolomycosis of the nose and face: a case report and a mini-review of unusual cases of basidiobolomycosis.
BACKGROUND
Subcutaneous zygomycosis is a chronic infection caused by fungus of the order Entomophthorales. It can have varying presentations and presents in the nose and face area with gradually progressing subcutaneous swelling that may be difficult to diagnose unless a strong suspicion of fungal involvement is maintained. We present a case of subcutaneous zygomycosis in a 35-year-old male patient, resident of a North Indian state. The patient was diagnosed to be suffering from subcutaneous zygomycosis, the causative agent being Basidiobolus ranarum identified on culture and lactophenol cotton blue mount preparation. He responded well to treatment with Itraconazole and Terbinafine and is asymptomatic on follow-up.


CONCLUSIONS
Involvement of the nose and subcutaneous tissues of the face in Basidiobolomycosis is rare. The infection is more common in children, but the case presented here is an adult. Its occurrence in a native of North India is also uncommon. Previous studies have mostly reported good response to potassium iodide therapy. Our patient responded well to Itraconazole. The presentation can be a diagnostic dilemma if fungal smear and culture is not sought, so this rare entity should be kept in mind in cases of indolent infections of the nose and facial soft tissues.
Goyal
Arun
A
Department of ENT, University College of Medical Sciences and GTB Hospital, Delhi, India.
Gupta
Neelima
N
Das
Shukla
S
Jain
Sarika
S
D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003881:Dermatomycoses / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D020091:Entomophthorales / Q000302:isolation & purification*; D005145:Face / Q000382:microbiology / Q000473:pathology*; D005260:Female; D006257:Head / Q000000981:diagnostic imaging; D006801:Humans; D007194:India; D007223:Infant; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use; D009666:Nose / Q000382:microbiology / Q000473:pathology*; D000077291:Terbinafine; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020096:Zygomycosis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology
D000935:Antifungal Agents; D009281:Naphthalenes; D017964:Itraconazole; D000077291:Terbinafine