Categories
ORGAN SYSTEMS Otolaryngeal system (ENT)

Rhinosporidiosis

Introduction

Chronic granulomatous disease caused by Rhinosporidium seeberi.

History:

Rhinosporidiosis is an enigmatic disease which has been known to medicine since 1900 following its first description by Guillermo Seeber in Buenos Aires, Argentina, who proposed the infective aetiology for this disease to be a fungus, which was later isolated by Ashworth in 1923, who in turn described the life cycle of the organism and established the nomenclature Rhinosporidium seeberi.

  • Disease is endemic in India, Sri Lanka, and tropical areas of Africa and South America
Areas of high incidence | Prakash, M., & Johnny, J. C. (2015). Rhinosporidiosis and the pond. Journal of pharmacy & bioallied sciences, 7(Suppl 1), S59–S62. https://doi.org/10.4103/0975-7406.155804

Aetiology

Rhinosporidum seeberi

Aquatic protista classified under Mesomycetozoea
  • Transmission occurs by bathing in stagnant ponds where animals also bathe.

Clinical features

Strawberry like bleeding polyp in the nose and in severe cases as disseminated rhinosporidiosis.

Showing rhinosporidial mass protruding out through left nasal cavity. | Karthikeyan, P., Vijayasundaram, S., & Pulimoottil, D. T. (2016). A Retrospective Epidemiological Study of Rhinosporidiosis in a Rural Tertiary Care Centre in Pondicherry. Journal of clinical and diagnostic research : JCDR, 10(5), MC04–MC8. https://doi.org/10.7860/JCDR/2016/17465.7788

Most commonly it affects the nose, although mucous membrane of the nasopharynx, oropharynx, conjunctiva, rectum, and external genitalia can also be involved.


Diagnosis

Excision biopsy:

Diagnosis is confirmed with excision biopsy of the lesion
  • Typical sporangia in tissue
A. Extraoral photograph of a patient depicting swelling on the right side of the face. B. Intraoral photograph depicting a non-healing ulcer on the lateral part of palate. C. Photomicrograph of a H&E stained section viewed at low magnification (×40) showing multiple mature and immature sporangia with numerous adipocytes. D. Photomicrograph of a periodic acid-Schiff (PAS) stained section viewed at low magnification (×100) showing magenta, thick walled sporangia. E. Photomicrograph of a PAS stained section viewed at high magnification (×400) showing magenta, thick walled sporangia. F. Photomicrograph of H&E stained section viewed at high magnification (×100) showing inflammatory infiltrate with giant cells. | Putthia, H., Manjunatha, B. S., Astekar, M., & Taufiq, S. (2018). Palatal rhinosporidiosis: an unusual case report and review of the literature. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 44(6), 293–297. https://doi.org/10.5125/jkaoms.2018.44.6.293

Management

Surgical management:

Treatment of choice
  • Surgical excision followed by cauterization of base (prevent recurrence)

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