RHINOSPORIDIOSIS

• Rhinosporidiosis is a chronic granulomatous infection of the mucous membranes.
• Manifests as vascular friable polyps that arise from the nasal mucosa or external structures of the eye.
• It is endemic in India and Sri Lanka.

CAUSE OF RHINOSPORIDIOSIS

• The etiologic agent is R seeberi.
• Rhinosporidium seeberi is an aquatic bacterium (not a fungus).
• Recent RNA gene analysis has placed R seeberi into a novel group of aquatic parasites of the class Mesomycetozoea.
• Most persons with rhinosporidiosis have had bathing or working exposure to stagnant water.

Although traditionally regarded as a fungus, it is now considered a protistan parasite belonging to the class Mesomycetozoea.

CLINICAL FEATURES

• Rhinosporidiosis is an infection that is typically limited to the mucosal epithelium. 
• Sex: Men are affected more commonly than women, with a male-to-female ratio of 4:1.Age:The disease most commonly occurs in children and in individuals aged 15-40 years.
  • Infection of the nose and nasopharynx is observed in 70% of persons with rhinosporidiosis.
  • Infection of the palpebral conjunctivae or associated structures (including the lacrimal apparatus) is observed in 15%.
• Nasal disease may present with unilateral nasal obstruction or epistaxis.

Other symptoms may include :

• local pruritus, coryza with sneezing, rhinorrhea, and postnasal discharge (drip) with cough.
  • Patients often report a sensation that a foreign body is present in their nasal canal.
  • Eye involvement is initially asymptomatic. 
  • Increased tearing may be reported as the disease progresses. 
  • Photophobia, redness, and secondary infection may occur.

Soft polyps may develop on the nose or eye.

• These polyps are pink to deep red, are sessile or pedunculated, and are often described as strawberrylike in appearance.
• This appearance results from sporangia, which is visible as gray or yellow spots in the vascular polypoid masses.
• Because the polyps of rhinosporidiosis are vascular and friable, they bleed easily upon manipulation.

TREATMENT

• Rhinosporidiosis is treated with surgical excision.C
• Complete excision of mass is done with diathermy knife & cauterization of base.
• Dapsone has been tried with some success.