International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
A bimodal analysis of clinical phenotypes and eosinophilic responses as prognostic indicators in gastrointestinal basidiobolomycosis.
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Chhetri Shabnam, Mohan P, Kamona Aws, Hashmi Al Warith Al, Sarfaraz Surkhab Khan Mohammad Suleman, Hashami Hilal Saif Mohamed Al, Khamis Faryal, Balushi Zakariya Al, Alrashdi Zakiya Mohammed Yahya, Busaidi Abdullah Al, Ansari Zainab Abdul Hameed, Ba'Omar Muna, Nassr Manar Mohammed, Masqri Mohammed Al, Darmaki Ahmed Al, Al-Abri Seif
Аннотация
OBJECTIVES: Gastrointestinal basidiobolomycosis (GIB) is an emerging infection caused by Basidiobolus ranarum (Entomophthorales), typically producing chronic granulomatous inflammation in immunocompetent hosts and remains under-recognized in endemic regions. We compared pediatric and adult disease trajectories and assessed whether absolute eosinophil count (AEC) is associated with outcome.
METHODS: We conducted a 10-year (2015-2024) single-center retrospective observational study at The Royal Hospital, Muscat, Oman, including 13 patients with GIB diagnosed primarily by characteristic histopathology, including the Splendore-Hoeppli phenomenon with eosinophil-rich inflammation, supported by clinical and radiologic findings; patients were stratified into pediatric (n = 7; mean age ∼4 years) and adult (n = 6; mean age ∼55 years) cohorts.
RESULTS: Children most often presented with fever and abdominal pain, whereas adults more commonly presented with weight loss, constipation, and/or an abdominal mass (malignancy-mimicking phenotype); mean AEC was significantly higher in children than adults (4.44 × 10⁹/L vs 1.85 × 10⁹/L, P = 0.035), and was the only laboratory parameter to differ significantly between groups. Mortality occurred only in adults (33.3% (2/6)); fatal cases demonstrated a blunted eosinophilic response (mean AEC ∼0.9 × 10⁹/L) compared to survivors (reported mean AEC ∼4.5 × 10⁹/L).
CONCLUSION: GIB demonstrates a bimodal clinical phenotype with adult-predominant mortality, and lower AEC may signal worse prognosis, warranting validation in larger multicenter cohorts.
METHODS: We conducted a 10-year (2015-2024) single-center retrospective observational study at The Royal Hospital, Muscat, Oman, including 13 patients with GIB diagnosed primarily by characteristic histopathology, including the Splendore-Hoeppli phenomenon with eosinophil-rich inflammation, supported by clinical and radiologic findings; patients were stratified into pediatric (n = 7; mean age ∼4 years) and adult (n = 6; mean age ∼55 years) cohorts.
RESULTS: Children most often presented with fever and abdominal pain, whereas adults more commonly presented with weight loss, constipation, and/or an abdominal mass (malignancy-mimicking phenotype); mean AEC was significantly higher in children than adults (4.44 × 10⁹/L vs 1.85 × 10⁹/L, P = 0.035), and was the only laboratory parameter to differ significantly between groups. Mortality occurred only in adults (33.3% (2/6)); fatal cases demonstrated a blunted eosinophilic response (mean AEC ∼0.9 × 10⁹/L) compared to survivors (reported mean AEC ∼4.5 × 10⁹/L).
CONCLUSION: GIB demonstrates a bimodal clinical phenotype with adult-predominant mortality, and lower AEC may signal worse prognosis, warranting validation in larger multicenter cohorts.