Rhinosporidiosis

Rhinosporidiosis
Classification and external resources
Rhinosporidiosis in oropharynx
ICD-10	B48.1
ICD-9	117.0
DiseasesDB	31328
eMedicine	med/2029
MeSH	D012227

Rhinosporidiosis is an infection caused by Rhinosporidium seeberi.

Classification

This organism was previously considered to be a fungus, and rhinosporidiosis is classified as a fungal disease under ICD-10.

It is now considered to be a parasite, classified under Mesomycetozoea.

Authors of detailed studies have revealed superficial similarities between Dermocystidium and Rhinosporidium when using light microscopy, but substantial morphological differences between the groups exist.

There is some evidence that DNA extracted from purified uncontaminated round bodies (Rhinosporidium seeberi) is of cyanobacterium origin.

Pathophysiology

Rhinosporidiosis is a granulomatous disease affecting the mucous membrane of nasopharynx, oropharynx, conjunctiva, rectum and external genitalia. Though the floor of the nose and inferior turbinate are the commonest sites, the lesions may appear in elsewhere too. Traumatic inoculation from one site to others is common. Laryngeal rhinosporidiosis too has been described and my be due to inoculation from the nose during endotracheal intubation. After inoculation the organism replicate locally resulting in the hyperplasia of host tissue and localised immune response.

• infection of nose and nasopharynx - 70%
• infection of palpebral conjunctiva - 15%

Epidemiology

Disease endemic in South India, Sri Lanka, South America and Africa. It is presumed to be transmitted by exposure to the pathogen when taking a bath in stagnant water pools.

Clinical Features

• History
  • Unilateral nasal obstruction
  • Epistaxis
  • Local pruritis
  • Rhinorrhea
  • Coryza with sneezing
  • Post nasal discharge with cough
  • Foreign body sensation
  • History of exposure to contaminant water
  • Increased tearing and photo phobia in cases of infection of palpebral conjunctiva
• On examination
  • Pink to deep red polyps
  • Strawberry like appearance
  • Bleeds easily upon manipulation
• Diagnosis
  • confirmed by biopsy- several round or oval sporangia and spores which may be seen bursting through its chitinous wall

Treatment

• Surgical excision - wide excision with electro-coagulation of the lesion base
• Medical treatment is not so effective but treatment with a year long course of dapsone has been reported