Bhadra TK, Lucke-Wold B. Letter to the Editor: Ileocecal basidiobolomycosis resembling malignancy - histopathological insights and a justification for nonsurgical therapy. World J Clin Cases 2026; 14(19): 121056 [DOI: 10.12998/wjcc.121056]
Corresponding Author of This Article
Brandon Lucke-Wold, MD, Lillian S. Wells Department of Neurosurgery, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, United States. brandon.lucke-wold@neurosurgery.ufl.edu
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Gastroenterology & Hepatology
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letter
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Bhadra TK, Lucke-Wold B. Letter to the Editor: Ileocecal basidiobolomycosis resembling malignancy - histopathological insights and a justification for nonsurgical therapy. World J Clin Cases 2026; 14(19): 121056 [DOI: 10.12998/wjcc.121056]
World J Clin Cases. Jul 6, 2026; 14(19): 121056 Published online Jul 6, 2026. doi: 10.12998/wjcc.121056
Letter to the Editor: Ileocecal basidiobolomycosis resembling malignancy - histopathological insights and a justification for nonsurgical therapy
Brandon Lucke-Wold, Tushar K Bhadra
Tushar K Bhadra, Department of General Surgery, Dhaka Medical College, Dhaka 1000, Bangladesh
Brandon Lucke-Wold, Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL 32608, United States
Co-first authors: Tushar K Bhadra and Brandon Lucke-Wold.
Author contributions: Bhadra TK and Lucke-Wold B contributed equally to this article, they are the co-first authors of this manuscript; Bhadra TK designed the overall concept and outline of the manuscript, and contributed to the writing and editing of the manuscript; Lucke-Wold B contributed to the discussion, design of the manuscript, and review of literature; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Brandon Lucke-Wold, MD, Lillian S. Wells Department of Neurosurgery, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, United States. brandon.lucke-wold@neurosurgery.ufl.edu
Received: March 16, 2026 Revised: April 13, 2026 Accepted: June 4, 2026 Published online: July 6, 2026 Processing time: 110 Days and 12.2 Hours
Abstract
Basidiobolomycosis usually manifests as persistent subcutaneous swelling and hardly infects the gastrointestinal tract. Due to infrequent gastrointestinal involvement along with nonspecific clinical signs, it frequently leads to misdiagnosed cases and treatment delays. Gastrointestinal basidiobolomycosis (GIB) should be recognized as a differential diagnosis in patients with abdominal pain, weight loss, eosinophilia, and an inflammatory mass refractory to non-antifungal therapy, especially if the patient hails from Iran, Saudi Arabia, Kuwait, or desert regions of the United States (primarily Arizona). Histopathological findings, including mixed inflammatory cells, especially eosinophilic infiltration, granulomatous reactions, broad, thin-walled, and aseptate hyphae, and Splendore-Hoeppli phenomenon (radiating intensely eosinophilic material) around fungal hyphae, are highly characteristic of GIB. In this editorial, we comment on the article published by Alsulaimi et al in the World Journal of Clinical Cases, showing a case of 32-year Saudi male with an ileocecal mass. It was confirmed to be GIB on histopathology and was treated by antifungal therapy alone. In this article, we emphasized the importance of histopathology in making the diagnosis of GIB and suggested that more polymerase chain reaction-based methods be used for early identification.
Core Tip: Gastrointestinal basidiobolomycosis is a rare fungal infection most seen in Iran, Saudi Arabia, and the desert areas of the United States. Unlike other fungal infections, it commonly occurs in immunocompetent individuals. Histopathological findings like the Splendore-Hoeppli phenomenon remains cornerstone of this infection diagnosis. While itraconazole is first line medication in most cases, posaconazole is utilized in treatment-refractory cases. Awareness should be raised in clinicians of endemic regions to consider gastrointestinal basidiobolomycosis as a differential diagnosis in patients presenting with an inflammatory ileocecal mass with eosinophilia.
