Rhinosporidiosis

• Rhinospoidiosis is a granulomatous disease of the nose caused by Rhinosporidium seeberi
• R. seeberi was initially thought to be a fungus, but now it is now considered to be an aquatic protistan
• Rhinosporidiosis is found in India (southern states mostly), Pakistan and Sri Lanka

Etiology

• There are various theories explaining the etiology of rhinosporidiosis
  • Demellow’s theory of infection – Infection arises from swimming in water bodies frequented by animals
  • Karunarathnae’s theory of auto inoculation – The spread of lesions to skin and conjunctiva occur as a result of auto inoculation
  • Hematogenous spread
  • Lymphatic spread

Clinical features

• Symptoms
  • epistaxis
  • nasal stuffiness
• Signs
  • Leafy, polypoidal, pink to pruple mass in nasal cavity, arising from lateral wall or nasal septum, sometimes extending to nasopharynx
  • White dots seen on surface – sporangia
  • Bleeds on touch

Investigations

• Diagnosis is confirmed by biopsy
• Biopsy shows sporangia with spores

Treatment

• Surgical excision with cauterisation of base
• Care should be taken to ensure complete removal so as to prevent recurrence
• Medical treatment is not very effective
• Dapsone has been tried for treatment of rhinosporidiosis