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Paediatric case of gastrointestinal basidiobolomycosis mimicking appendicitis – Case report

机译:模仿阑尾炎的胃肠道杆菌菌病小儿病例–病例报告

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Introduction Basidiobolomycosis is a rare fungal infection caused by Basidiobolus ranarum that normally leads to subcutaneous infection and, rarely, to involvement in the gastrointestinal tract. Presentation of case A 6-year-old boy presented to the Emergency department (ED) complaining of abdominal pain of a few weeks’ duration in the right lower quadrant, associated with fever and vomiting. A computed tomography (CT) of the abdomen was done. It showed an enlarged tubular structure in the right iliac fossa, a suspected appendicular lesion, and free fluid collection, as well as multiple enlarged mesenteric and right iliac lymph nodes. Based on these results, the decision was made to do surgical exploration on the patient. After two weeks, the patient developed tachycardia, abdominal distention, constipation, and spikes of fever. Two days later, re-exploration was performed. An ileostomy and colostomy were performed and drains inserted. Post-operative, the patient was pushed to paediatric intensive care unit (PICU), while still intubated and hemodynamically stable. However, he developed cardiac arrest on the same day and cardiopulmonary resuscitation (CPR) was performed, but he couldn't be resuscitated. Discussion The patient presented with severe abdominal pain in the right lower quadrant, as well as fever and vomiting. These complaints may have been misdiagnosed as appendicitis. The diagnosis of gastrointestinal basidiobolomycosis was confirmed by histopathology, based on a surgical specimen taken during the primary exploration. The management was a combination between surgical intervention and medical treatment.
机译:引言Basidiobolomycosis是一种罕见的真菌感染,它由Ranasum Basidiobolus引起,通常会导致皮下感染,很少会累及胃肠道。病例介绍一名送往急诊室(ED)的6岁男孩抱怨右下腹持续数周的腹痛,伴有发烧和呕吐。腹部CT(CT)检查完成。它显示出右窝的管状结构增大,可疑的阑尾病变和自由积液,以及多个肠系膜和右淋巴结肿大。基于这些结果,决定对患者进行手术探查。两周后,患者出现心动过速,腹胀,便秘和发烧高峰。两天后,进行了重新探索。进行回肠造口术和结肠造口术,并插入引流管。术后,患者仍被插管且血流动力学稳定,被推入小儿重症监护病房(PICU)。但是,他在同一天出现心脏骤停,并进行了心肺复苏(CPR),但无法进行复苏。讨论该患者右下腹出现严重的腹痛,以及发烧和呕吐。这些主诉可能被误诊为阑尾炎。根据在初步探索期间采集的手术标本,通过组织病理学证实了对胃肠道杆菌病的诊断。管理是手术干预和药物治疗之间的结合。

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