Cutaneous basidiobolomycosis: Seven cases in southern Benin

Autor: M.-C. Koeppel, Christiane Koudoukpo, D. Chabasse, H. Yedomon, J. Gnossikè, Y. Sissinto-Savi de Tovè, Félix Atadokpèdé, A. Chauty, Hugues Adegbidi, Bérénice Dégboé, F do-Ango-Padonou, M T Dieng, J P Saint-André, A Adéyé
Rok vydání: 2017
Předmět:
Zdroj: Annales de Dermatologie et de Vénéréologie. 144:250-254
ISSN: 0151-9638
Popis: Summary Background Cutaneous basidiobolomycosis is the most common form of entomophthoramycosis. Herein we report seven cases of cutaneous basidiobolomycosis. Patients and methods A retrospective observational study was conducted at the Buruli ulcer treatment centre in Pobe and at the national teaching hospital in Cotonou from 2010 to 2015. Results Seven cases of cutaneous basidiobolomycosis were diagnosed. The mean patient age was 9.53 years. There were 4 female and 3 male patients, all from southeast Benin. Clinically, the disease presented in all cases as a hard, well-defined, subcutaneous plaque with little inflammation, and which could easily be lifted from the deep structures but remained attached to the surface structures. The overlying skin was hyperpigmented. Plaques were localized to the buttocks or thighs. All patients had inflammatory anaemia with an accelerated erythrocyte sedimentation rate (30 to 70 mm over the first hour), and a low haemoglobin count (8.7 to 11.4 g/dL). Blood hypereosinophilia (650 to 3784 elements/mm3) was present in six of the seven subjects. Histopathology (performed for 5 of the 7 subjects) showed granulomatous lesions with foreign-body giant cells, and inflammatory cells, with occasional eosinophils surrounding fungal hyphae (Splendore-Hoeppli phenomenon). Mycological analysis revealed Basidiobolus ranarum in three cases. The patients were treated with ketoconazole (5/7) and itraconazole (2/7), with good outcomes after 10 to 24 weeks of therapy. Discussion Cutaneous basidiobolomycosis is uncommon in southern Benin, with only seven cases being diagnosed over 6 years. The diagnosis of cutaneous basidiobolomycosis is a challenge in the field in Benin due to the non-specific clinical presentation, the lack of technical resources, and the existence of numerous differential diagnoses. Conclusion Cutaneous basidiobolomycosis is an uncommon fungal infection in southern Benin chiefly affecting children.
Databáze: OpenAIRE