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This report illustrates the successful removal of a proper intra-orbital oculosporidiosis (extralacrimal, extraconjunctival) exclusively by the endonasal endoscopic approach. It also introduces the naso-orbital pseudofontanelle as an important surgical landmark and describes a hitherto undefined intra-orbital extramucosal three-dimensional potential wedge that harbored the Rhinosporidium seeberi infestation as a nodular conglomerate. The patient, a 50-year-old woman, was operated on three years ago for rhinosporidiosis of the nasal cavity and the distal lacrimal drainage system (lacrimal sac and nasolacrimal duct). The resulting alterations in regional anatomy were evident on imaging. They could explain the present recurrence and formation of the pseudofontanelle that allowed the conglomerate to bulge through the lateral nasal wall on digital pressure, making endoscopic intervention feasible. The primary principle for adopting this approach was to protect the facial skin from possible seeding. With an angled endoscope, the pseudofontanelle was breached and the intra-orbital extramucosal wedge between the bony orbital wall and the peri-orbita entered. The nodules that formed the conglomerate were densely adherent with the peri-orbita and skin. They were carefully and meticulously removed to avoid inadvertent injury to vital intra-orbital structures. Endonasal endoscopic intervention for a true intra-orbital oculosporidiosis has never been documented before. The surgical approach, the newly defined anatomical domain for the intra-orbital extramucosal oculosporidiosis, and the concept of pseudofontanelle characterize this report as a novel clinical experience worth presenting. [ABSTRACT FROM AUTHOR]

Objective: This study aims to present a series of patients with disseminated rhinosporidosis with diagnostic and therapeutic features. Methods: A retrospective study was conducted in a tertiary health care centre in South India from 2007 to 2020 with disseminated rhinosporidiosis. Twelve patients with multiple sites of involvement like the nose, nasopharynx, oropharynx, larynx, lacrimal sac and skin were included in the study. All patients underwent surgical excision, followed by peroral dapsone for one year. Results: The age group was around 30-55 years, with male predominance (11:1). Pond bathing history was present in 50% (n=6). The most common site of lesion was the nose (100%), oropharynx (83.3%), skin (75%), larynx (50%) and less commonly, nasopharynx (41.6%) and lacrimal sac (25%). One patient underwent surgery four times (8.3%), followed by thrice and twice by five (41.6%) and six (50%) patients, respectively. On two years of follow-up, two patients (16.6%) had a recurrence in the nose and larynx whereas eight patients (66.6%) had no recurrence and two patients (16.6%) were lost to follow-up. Conclusion: This original article highlights the rare occurrence of disseminated rhinosporidiosis, the possibility of which should be kept in mind, mainly when two or more sites are involved. The most significant number of disseminated rhinosporidiosis cases in the literature is reported here. Dissemination with the cutaneous and multisite disease is rarely reported and poses difficulty in management. Early diagnosis and intervention prevent the dissemination of spores into various parts of the body.

We describe a classic case of nasal rhinosporidiosis in a woman who resided in Johannesburg, South Africa, but originated from a rural area in Eastern Cape Province. We confirmed histologic diagnosis using PCR testing and compared details with those from records on 17 other cases from South Africa.

Skin and soft tissue infections (SSTIs) result from microbial invasion and may be mono or polymicrobial in etiology. The present retrospective record based study described five uncommon SSTIs from a medical college hospital of West Bengal. Clinical samples were collected and processed following standard microbiological procedures and guidelines. Identification and antimicrobial susceptibility testing of etiological agents, wherever applicable, were done by conventional and automated (Vitek-2 Compact) system. We found a case of spontaneous gas gangrene caused by Clostridium septicum, Group-A â-hemolytic Streptococcus mediated necrotizing fasciitis; lesions of Burkholderia pseudomallei and Burkholderia cepacia complex and that of disseminated rhinosporidiosis caused by Rhinosporidium seeberi. We infer that strong clinical suspicion may surface uncommon etiology from unusual presentations of SSTIs making their diagnosis, treatment and relief rapid and uneventful. [ABSTRACT FROM AUTHOR]

Rhinosporidiosis is a rarely encountered granulomatous infection caused by Rhinosporidium seeberi affecting both humans and animals. Although the disease has been reported worldwide, it is mainly endemic in tropical and subtropical countries. In the Indian subcontinent, it is endemic in some parts like Orissa, Tamil Nadu, Kerala, eastern Madhya Pradesh, and Chhattisgarh. It is a chronic granulomatous disease with varied controversial taxonomical history, but recently based on genetic sequencing and the nature of aquatics, it was later identified as an aquatic eukaryote. The mucous membranes are frequently impacted in humans, with a typical manifestation being the presence of a polypoidal mass. The occurrence of Rhinosporidiosis in nonendemic regions is uncommon. We report one such case of a young male with recurrent Rhinosporidiosis from India. [ABSTRACT FROM AUTHOR]

Skin and soft tissue infections (SSTIs) result from microbial invasion and may be mono or polymicrobial in etiology. The present retrospective record-based study described five uncommon SSTIs from a medical college hospital of West Bengal. Clinical samples were collected and processed following standard microbiological procedures and guidelines. Identification and antimicrobial susceptibility testing of etiological agents, wherever applicable, were done by conventional and automated (Vitek-2 Compact) system. We found a case of spontaneous gas gangrene caused by Clostridium septicum, Group-A â-hemolytic Streptococcus mediated necrotizing fasciitis; lesions of Burkholderia pseudomallei and Burkholderia cepacia complex and that of disseminated rhinosporidiosis caused by Rhinosporidium seeberi. We infer that strong clinical suspicion may surface uncommon etiology from unusual presentations of SSTIs making their diagnosis, treatment and relief rapid and uneventful.

Rhinosporidiosis, an infectious granulomatous disease, is seldom encountered in the United States. We present a case of rhinosporidiosis in a 26-year-old man, who presented with an unusual mass in his nasal cavity. Suspicion for rhinosporidiosis was high due to the patient's travel and activity history. After imaging and proper diagnosis, surgery was performed to excise the lesion. As international travel resumes during the COVID-19 pandemic, the potential for encountering this rare organism is heightened. [ABSTRACT FROM AUTHOR]

Rhinosporidiosis is one of the granulomatous diseases endemic in Asia, Africa, and Europe, with Southern India and Sri Lanka having the greatest prevalence rates. It is typically understood to affect the upper respiratory system. Involvement of the lungs beyond the trachea is infrequent as compared to the upper respiratory tract. We revealed an uncommon case of disseminated rhinosporidiosis in a diabetic patient, who initially presented with shortness of breath associated with cough and fever. Two months prior to these symptoms, he was having oral ulcer and dysphagia and, subsequently, loss of weight. Chest radiograph and CT thorax revealed military nodules with multiple suppurative neck and mediastinal lymphadenopathy and bilateral adrenal lesions. He was initially investigated for tuberculosis, metastatic malignancy, or lymphangitic carcinomatosis before a biopsy revealed Rhinosporidiosis. Hence, histopathological or laboratory evidence is frequently crucial to back up imaging concerns so the appropriate treatment can be given.

Rhinosporidiosis is an endemic condition in India that is difficult to treat when it is disseminated. This condition commonly affects the nasal cavity and nasopharynx mucosa, accounting for 75% of the clinical cases. Although rare, rhinosporidiosis can present with only cutaneous involvement without mucosal disease. Symptoms of this condition include complaints of nasal obstruction and episodic nasal bleeding. Diagnosis is achieved through histopathological examination of tissue and demonstration of the sporangium. Rhinosporidiosis tends to recur as it spreads through autoinoculation. Therefore, during endonasal endoscopic excision of the mass, it is essential not to injure the surrounding mucosa. A trial of medical therapy with dapsone is advised, but it is mostly ineffective in cases of disseminated disease. Here, we present a case report of a patient who underwent seven surgeries for the same condition over 12 years but was unable to get rid of the recurrent menace. [ABSTRACT FROM AUTHOR]

Rhinosporidiosis is a chronic granulomatous infection caused by Rhinosporidium seeberi endemic in India, commonly in Tamil Nadu, Karnataka, Pondicherry, Chhattisgarh, etc. Ocular rhinosporidiosis though uncommon can affect the conjunctiva, lacrimal sac, sclera, and eyelids. In the conjunctiva, the palpebral conjunctiva is affected the most. Here, we discuss a case of a 14-year-old male who presented with a polypoidal mass in the bulbar conjunctiva mimicking a pyogenic granuloma, which on excision biopsy was confirmed as rhinosporidiosis. Diagnosis is based mainly on strong clinical suspicion and can be confirmed on excision biopsy.

Tewodros Wubshet Desta,1 Abdo Kedir2 1Department of Pathology, Dire Dawa University, Dire Dawa, Ethiopia; 2Department of Pathology, Jimma University Medical Center, Jimma, EthiopiaCorrespondence: Tewodros Wubshet Desta, Department of Pathology, Dire Dawa University, Po Box 1362, Dire Dawa, Ethiopia, Tel +251-931262484, Fax +251-251127971, Email theddo04@gmail.comBackground: Rhinosporidiosis is a chronic infectious disease caused by an infection with the sporulating bacterium Rhinosporidium seeberi. It primarily affects the nose and nasopharynx mucous membranes, but it can also involve the conjunctiva. The most common presentation of ocular rhinosporidiosis is a polypoid mass in the palpebral conjunctiva. It affects people of all ages and genders and is found in few Asian countries. Conjunctival lesions are uncommon, and no previous case from Ethiopia has been documented to the authors’ knowledge.Case Presentation: A 12-year-old boy with a fleshy pedunculated conjunctival mass was brought to Jimma University Medical Center with a 1-month history of foreign body sensation. The patient was diagnosed with Pedunculated Squamous Cell Papilloma and had an excisional biopsy of the lesion. The mass was found to be a hyperplastic polypoid lesion with numerous globular cysts within the conjunctival submucosa, surrounded by a heavy inflammatory infiltrate of lymphocytes, plasma cells, and neutrophils, as well as large thick-walled sporangia with numerous endospores on microscopic sections. Conjunctival Rhinosporidiosis was diagnosed histopathologically.Conclusion: In terms of clinical appearance, conjunctival Rhinosporidiosis resembles squamous papilloma. As a result, a thorough histopathologic study is essential for a correct diagnosis of this uncommon condition.Keywords: ocular, rhinosporidiosis, histopathology, Ethiopia

Rhinosporidiosis is a chronic infectious disease caused by an infection with the sporulating bacterium rhinosporidium seeberi. It mostly affects the nose and nasopharynx mucous membranes, but it can also affect the conjunctiva uncommonly. Ocular rhinosporidiosis is most commonly shown as a polypoid tumor in the palpebral conjunctiva. It affects people of all ages and genders. This case is important because there are few case reports in the world, and it is the second case to be reported from Ethiopia. A 14-year-old boy presented with painless, reddish-pink, fleshy mass on the left eye for 8 months duration. The patient was diagnosed with pyogenic granuloma clinically and had an excisional biopsy of the lesion. Conjunctival rhinosporidiosis was diagnosed histopathologically. Rhinosporidiosis is a granulomatous infection that affects the mucosal membranes of the nose, mouth, eyes, genitalia, and the rectal mucosa caused by rhinosporidium seeber, an aquatic protistan parasite. Histopathology on biopsied or resected tissues allows for a definitive diagnosis of rhinosporidiosis as well as the identification of the pathogen in various stages. This case was confirmed to be conjunctival rhinosporidiosis. In terms of clinical appearance, conjunctival rhinosporidiosis resembles pyogenic granuloma. As a result, a thorough histopathologic study is essential for a correct diagnosis of this uncommon condition. • Rhinosporidiosis is a chronic infectious disease caused by an infection with the sporulating bacterium Rhinosporidium seeberi. • Conjunctival rhinosporidosis are uncommon. • In terms of clinical appearance, conjunctival Rhinosporidiosis resembles different conjunctival lesions like pyogenic granuloma. • Histopathology allows for a definitive diagnosis of rhinosporidiosis as well as the identification of the pathogen in various stages. • The treatment of choice is complete surgical excision with or without cautery at the base. [ABSTRACT FROM AUTHOR]

Purpose: Though rhinosporidiosis of the lacrimal sac is a rare disease across the globe, the frequency with which these patients come to the outpatient department in western Odisha is quite alarming. This study was undertaken to upgrade the knowledge about the clinical profile and management of rhinosporidiosis of the lacrimal sac. Methods: This is a retrospective study comprising 32 clinically diagnosed and histopathologically proved cases of lacrimal sac rhinosporidiosis who were managed with dacryocystectomy with meticulous excision. Intraoperative copious irrigation with 5% povidone–iodine for 5 min and postoperative dapsone therapy for 3–6 months had been administered to all the patients. The mean follow-up period was 16.7 months. The study was conducted over 5 years from August 2015 to July 2020. Results: Rhinosporidium seeberi, an aquatic protistan parasite, was found to be the causative agent. Males and females were affected equally. Children less than 10 years of age comprised 56.2% (18 cases). History of pond bathing was found in 100% of cases. The most common presentation was boggy swelling over the lacrimal sac. The involvement was unilateral in all the cases. None of the patients were found to have nasal involvement. In 65.6%, the lesion was limited within the sac. Recurrence was noted in 25% of cases. Conclusion: Rhinosporidiosis of the lacrimal sac should be excluded in all patients presenting with boggy swelling of the lacrimal sac with a history of pond bath. The recurrence can be minimized by meticulous excision, intraoperative betadine, and postoperative dapsone therapy.

Rhinosporidiosis is a chronic granulomatous fungal infection caused by Rhinosporidium seeberi. Usual site of infection is the nasal mucosa & nasopharynx. Male urethra is extremely rare site involving this disease. Here we are reporting a rare case where rhinosporidiosis presented as a prolapsing mass from urethra during voiding.

Rhinosporidiosis is a chronic, granulomatous, muco-cutaneous infection caused by Rhinosporidium seeberi. The infection is non-contagious and sporadic in humans, affecting predominantly the mucous membrane of the upper respiratory tract. It is quite an uncommon condition and seldom affects the oral mucosa. The clinical presentation of this condition in the oral cavity can mimic many other conditions. Here, we report a unique case of recurrent rhinosporidiosis affecting the palate in a 54-year-old male. [ABSTRACT FROM AUTHOR]

Introduction Choanal polyps are benign lesions arising from the sinonasal mucosa, extending through the choana into the nasopharynx. Though polyps arising from the maxillary sinus and extending to the choana are common, polyps arising from the sphenoid sinus ostium, posterior part of middle turbinate, and inferior and middle meatus are quite uncommon. Objective To document the site of origin of choanal polyps arising fromunusual sites; their clinical, radiological, and histopathological characteristics, as well as diagnostic challenges and management. Methods This retrospective, single-center study included 14 patients aged 16 to 75-years-old with choanal polyps. After obtaining informed consent, their clinical, radiological and surgical details and histopathology reports were reviewed. Patients were followed for at least 6 months after surgery. Results The predominant symptoms were unilateral nasal obstruction (n=9), snoring, rhinorrhea, and epistaxis. Though anterior rhinoscopy was unremarkable, a mass could be visualized during posterior rhinoscopy in the nasopharynx in 11 patients, and a mass could be directly visualized in the oropharynx in 2 patients. After diagnostic by nasal endoscopy, these polyps were noted to arise from the posterior aspect of the middle meatus (n=6), middle turbinate (n=3), posterior septum (n=3), sphenoid sinus ostium (n=1), and inferior meatus (n=1). All patients were managed surgically. The histopathological examination revealed inflammatory polyp (n=12), actinomycosis (n=1), and rhinosporidiosis (n=1). Patients were followed up for 6 to 22 months. We observed no complications or recurrence. Conclusion Diagnostic nasal endoscopy should be performed in all patients presenting with nasal obstruction, to rule out choanal polyps arising from unusual sites. Complete polyp removal and appropriate treatment based on histopathology prevents recurrence. [ABSTRACT FROM AUTHOR]

Rhinosporidiosis is a chronic granulomatous disease involving the mucous membranes of nose and nasopharynx caused by Rhinosporidium seeberi. Rhinosporidiosis involving the eye is known as Oculosporidiosis. Usually affected patients present with nasal obstruction with an associated mass, epistaxis and watery discharge. In our case, there was involvement of the nasolacrimal duct which resulted in bloody discharge from the punctum. [ABSTRACT FROM AUTHOR]

Rhinosporidiosis is a chronic granulomatous disease affecting mucosal membranes, particularly in tropical and subtropical regions. This case report presents a young male from Santhal Pargana, Jharkhand, who presented with nasal obstruction, epistaxis, and a mass in the right nasal cavity. Surgical excision and histopathological analysis confirmed rhinosporidiosis. Although no definitive medical treatment exists, surgical excision with cauterization remains the most effective method to prevent recurrence. This report marks the first documentation of nasal rhinosporidiosis in Santhal Pargana, Jharkhand., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bano et al.)

Objective: This study aims to present a series of patients with disseminated rhinosporidosis with diagnostic and therapeutic features., Methods: A retrospective study was conducted in a tertiary health care centre in South India from 2007 to 2020 with disseminated rhinosporidiosis. Twelve patients with multiple sites of involvement like the nose, nasopharynx, oropharynx, larynx, lacrimal sac and skin were included in the study. All patients underwent surgical excision, followed by peroral dapsone for one year., Results: The age group was around 30-55 years, with male predominance (11:1). Pond bathing history was present in 50% (n=6). The most common site of lesion was the nose (100%), oropharynx (83.3%), skin (75%), larynx (50%) and less commonly, nasopharynx (41.6%) and lacrimal sac (25%). One patient underwent surgery four times (8.3%), followed by thrice and twice by five (41.6%) and six (50%) patients, respectively. On two years of follow-up, two patients (16.6%) had a recurrence in the nose and larynx whereas eight patients (66.6%) had no recurrence and two patients (16.6%) were lost to follow-up., Conclusion: This original article highlights the rare occurrence of disseminated rhinosporidiosis, the possibility of which should be kept in mind, mainly when two or more sites are involved. The most significant number of disseminated rhinosporidiosis cases in the literature is reported here. Dissemination with the cutaneous and multisite disease is rarely reported and poses difficulty in management. Early diagnosis and intervention prevent the dissemination of spores into various parts of the body., Competing Interests: Conflict of Interest: The authors have no conflict of interest to declare., (©Copyright 2024 by Turkish Otorhinolaryngology- Head and Neck Surgery Society / Turkish Archives of Otorhinolaryngology is published by Galenos Publishing House.)

Introduction Choanal polyps are benign lesions arising from the sinonasal mucosa, extending through the choana into the nasopharynx. Though polyps arising from the maxillary sinus and extending to the choana are common, polyps arising from the sphenoid sinus ostium, posterior part of middle turbinate, and inferior and middle meatus are quite uncommon. Objective To document the site of origin of choanal polyps arising from unusual sites; their clinical, radiological, and histopathological characteristics, as well as diagnostic challenges and management. Methods This retrospective, single-center study included 14 patients aged 16 to 75-years-old with choanal polyps. After obtaining informed consent, their clinical, radiological and surgical details and histopathology reports were reviewed. Patients were followed for at least 6 months after surgery. Results The predominant symptoms were unilateral nasal obstruction (n = 9), snoring, rhinorrhea, and epistaxis. Though anterior rhinoscopy was unremarkable, a mass could be visualized during posterior rhinoscopy in the nasopharynx in 11 patients, and a mass could be directly visualized in the oropharynx in 2 patients. After diagnostic by nasal endoscopy, these polyps were noted to arise from the posterior aspect of the middle meatus (n = 6), middle turbinate (n = 3), posterior septum (n = 3), sphenoid sinus ostium (n = 1), and inferior meatus (n = 1). All patients were managed surgically. The histopathological examination revealed inflammatory polyp (n = 12), actinomycosis (n = 1), and rhinosporidiosis (n = 1). Patients were followed up for 6 to 22 months. We observed no complications or recurrence. Conclusion Diagnostic nasal endoscopy should be performed in all patients presenting with nasal obstruction, to rule out choanal polyps arising from unusual sites. Complete polyp removal and appropriate treatment based on histopathology prevents recurrence.

Background: Rhinosporidiosis is a rare chronic granulomatous disease caused by Rhinosporidium seeberi. It is endemic in some parts of Asia and commonly involves the mucous membrane of the nose presenting with nasal obstruction, a nasal mass, and epistaxis. The main treatment for rhinosporidiosis remains surgical excision, although it may recur after excision. Rhinosporidiosis is a condition that clinicians should keep in mind when managing patients with nasal masses even in non-endemic areas. Case presentation: A 52-year-old housewife presented with a 9-month history of left progressive nasal obstruction and progressive enlarging left nasal growth associated with recurrent nasal bleeding and nasal discharge. She had a history of rearing animals and bathing in ponds as well as engaging in farming activities. Examination revealed a fleshy polypoid mass attached to the nasal septum by pedicle and filling the whole of the left nasal cavity covered with a mucopurulent nasal discharge with associated contact bleeding. She had endoscopic resection under local anaesthesia with cauterization of the base of the mass with a silver nitrate pencil. A histopathological diagnosis of rhinosporidiosis was made. Conclusion: Rhinosporidiosis is rare in our environment, its presentation mimics that of nasal tumours. Therefore, it should be part of the differential diagnosis; both clinicians and pathologists should have it at the back of their minds when managing patients with nasal masses even in non-endemic areas.

To emphasise the importance and possibility of a rare infective condition caused by Rhinosporidium seeberi presented with a vascular mass. A 50-year-old male presented with complaints of a recently noted red mass in his left eye causing irritation. Ocular examination revealed the presence of a large, red vascular mass with numerous greyish-white spots (Fish egg-like appearance) on its surface with feeder vessels. A provisional diagnosis of conjunctival hemangioma was made and planned for excision. The mass was excised and sent for biopsy. It did not require grafting. Histopathological examination revealed a structure of polypoidal mucosal inflammation studded with multiple double-walled sporangia containing endospores in a swiss cheese pattern suggestive of rhinosporidiosis. Rhinology consultation was normal. No recurrence is noted during the follow-up period of 18 months. Bulbar conjunctival involvement is relatively rare. 'Fish egg' appearance aids in the diagnosis and histopathology confirms it. Excision is the only treatment.

Being rare, rhinosporidiosis is a chronic granulomatous disease that is characterized by polypoidal lesions of the mucous membrane and is caused by Rhinosporidium seeberi. The disease commonly affects the mucous membrane of the nasopharynx, conjunctiva, and palate and its very rare in our geographical location. Nasal rhinosporidiosis lesions may greatly mimic other ordinary nasal polyps, and it is crucial for otorhinolaryngologists to consider rhinosporidiosis as a differential diagnosis whenever encountering patients with nasal masses during routine clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Though rhinosporidiosis of the lacrimal sac is a rare disease across the globe, the frequency with which these patients come to the outpatient department in western Odisha is quite alarming. This study was undertaken to upgrade the knowledge about the clinical profile and management of rhinosporidiosis of the lacrimal sac.Methods: This is a retrospective study comprising 32 clinically diagnosed and histopathologically proved cases of lacrimal sac rhinosporidiosis who were managed with dacryocystectomy with meticulous excision. Intraoperative copious irrigation with 5% povidone-iodine for 5 min and postoperative dapsone therapy for 3-6 months had been administered to all the patients. The mean follow-up period was 16.7 months. The study was conducted over 5 years from August 2015 to July 2020.Results: Rhinosporidium seeberi, an aquatic protistan parasite, was found to be the causative agent. Males and females were affected equally. Children less than 10 years of age comprised 56.2% (18 cases). History of pond bathing was found in 100% of cases. The most common presentation was boggy swelling over the lacrimal sac. The involvement was unilateral in all the cases. None of the patients were found to have nasal involvement. In 65.6%, the lesion was limited within the sac. Recurrence was noted in 25% of cases.Conclusion: Rhinosporidiosis of the lacrimal sac should be excluded in all patients presenting with boggy swelling of the lacrimal sac with a history of pond bath. The recurrence can be minimized by meticulous excision, intraoperative betadine, and postoperative dapsone therapy. [ABSTRACT FROM AUTHOR]

Rhinosporidiosis is a chronic granulomatous infection of the nose and nasopharynx. It is endemic in South Asia and commonly affects males in their second to fourth decades of life. Majority of the cases are found in the upper respiratory tract such as anterior nares, nasal cavity, inferior turbinate, nasal septum, floor, and nasopharynx. Although nose or nasopharynx is the most common location for rhinosporidiosis, it can also involve the skin, parotid duct, oropharynx, and larynx. Here, we report the case of a 42-year-old male who presented with extensive rhinosporidiosis in both nasal cavities and nasopharynx along with involvement of the roof of the oral cavity through erosion of the hard palate. The mainstay of treatment is wide excision followed by electrocautery of the base which ablates the recurrence. The rhinosporidiosis mass from different sites of the attachment was completely excised along with cauterization of the base. The diagnosis was confirmed by histopathological report.

Rhinosporidiosis is a granulomatous disease caused by Rhinosporidium seeberi which belongs to class Mesomycetozoea. It mainly affects mucous membranes of the nose, nasopharynx, and oropharynx. It can also involve uncommon sites of the human body to disseminated types. Water and soil act as a reservoir for this organism. Isolated involvement of the palatine tonsil by rhinosporidiosis is extremely uncommon. Extra-nasal manifestations of rhinosporidiosis are relatively uncommon in clinical practice. Tonsillar rhinosporidiosis is extremely rare and often confused with oropharyngeal tumors. The mainstay of treatment of rhinosporidiosis is surgical excision by coblation, laser, or electric diathermy. Here, we report a 32-year-old man presented with a red, polypoidal mass of the palatine tonsil and bleeding occasionally and the diagnosis of rhinosporidiosis was confirmed by histopathological examination. The mass was completely removed along with the tonsil by coblation technique and the base was coagulated under general anesthesia. Hence, the possibility of this atypical site of rhinosporidiosis should be included in the clinical differential diagnosis of any pinkish mass originating from the palatine tonsil, particularly in the endemic area.

Abstract Being rare, rhinosporidiosis is a chronic granulomatous disease that is characterized by polypoidal lesions of the mucous membrane and is caused by Rhinosporidium seeberi. The disease commonly affects the mucous membrane of the nasopharynx, conjunctiva, and palate and its very rare in our geographical location.

Rhinosporidiosis is a type of nasal polypoidal growth arising from the mucosa of nasal cavity and often extending to nasopharynx. Occasionally, this growth may invade the lower airways and cause airway obstruction. The clinical presentation of such cases is often contradictory and airway management during induction of anesthesia requires caution to prevent potential life-threatening situations. A case of large pedunculated rhinosporidiosis involving the epiglottis and laryngeal inlet, with significant airway management challenge has been presented here. Clinical significance: Primary care physicians should be diligent in evaluating patients with rhinosporidiosis and look for signs of airway obstruction to rule out lower airway involvement.

A vegetative growth in the nasal mucosa and nasopharynx present for a considerable period of time raises the possibility of rhinosporidiosis. Such presentation in the Indian subcontinent is not rare but erythematous cauliflower-like or tumor-like growths often reaching large size present on various areas of the skin without necessarily involving the nasal apparatus are often confusing to the attending clinician. A dermatologist may suspect the disseminated form of cutaneous rhinosporidiosis and perform a diagnostic histopathology. Early institution of treatment may give significant relief to the patient.

Introduction Rhinosporidiosis is a granulomatous disease of humans and animals that is caused by Rhinosporidium Seeberi. This disease is endemic in certain states of India, like Chhattisgarh, Tamil Nadu, Kerala, Orissa, and eastern Madhya Pradesh. We conducted a retrospective, record-based study in the department of ENT & Head and Neck Surgery of a tertiary case institute in Chhattisgarh. Objective To study the epidemiology of rhinosporidiosis, especially host risk factors. Methods We conducted a retrospective, record-based study in the department of ENT & Head and Neck Surgery of a tertiary case institute in Chhattisgarh, India. A total of 55 histologically proven rhinosporidiosis patients who were surgically treated in the department over a period of 2 years from November 2014 to November 2016 were included. Results This study involved 55 histologically proven rhinosporidiosis cases. There were 87% males and 12% females. Most of the cases belonged to lower socioeconomic status (92.73%). All the cases had history of pond bathing. Of 55 cases, 27 cases (49.09%) had O+ blood group followed by A+ in 10 (18.18%), B+ in 9 (16.36) and AB+ in 9 (16.36%). Conclusion The results of the study showed that the disease was associated with the male gender, young and middle age, low socioeconomic status, rural background, pond bathing and O+ blood group. [ABSTRACT FROM AUTHOR]

Introduction Rhinosporidiosis is a granulomatous disease of humans and animals that is caused by Rhinosporidium Seeberi. This disease is endemic in certain states of India, like Chhattisgarh, Tamil Nadu, Kerala, Orissa, and eastern Madhya Pradesh. We conducted a retrospective, record-based study in the department of ENT & Head and Neck Surgery of a tertiary case institute in Chhattisgarh. Objective To study the epidemiology of rhinosporidiosis, especially host risk factors. Methods We conducted a retrospective, record-based study in the department of ENT & Head and Neck Surgery of a tertiary case institute in Chhattisgarh, India. A total of 55 histologically proven rhinosporidiosis patients who were surgically treated in the department over a period of 2 years from November 2014 to November 2016 were included. Results This study involved 55 histologically proven rhinosporidiosis cases. There were 87% males and 12% females. Most of the cases belonged to lower socioeconomic status (92.73%). All the cases had history of pond bathing. Of 55 cases, 27 cases (49.09%) had O+ blood group followed by A+ in 10 (18.18%), B+ in 9 (16.36) and AB+ in 9 (16.36%). Conclusion The results of the study showed that the disease was associated with the male gender, young and middle age, low socioeconomic status, rural background, pond bathing and O+ blood group.

Rhinosporidiosis is a granulomatous disease caused by Rhinosporidium seeberi, mostly affecting the nasal mucosa. Extranasal involvement is also reported involving eyes, oral cavity, and skin. Herein, we present a rare case of a patient with disseminated rhinosporidiosis who presented with pulmonary lesions which resembled metastasis.

Rhinosporidiosis is a granulomatous disease caused by Rhinosporidium seeberi which belongs to class Mesomycetozoea. It mainly affects mucous membranes of the nose, nasopharynx, and oropharynx. It can also involve uncommon sites of the human body to disseminated types. Water and soil act as a reservoir for this organism. Isolated involvement of the palatine tonsil by rhinosporidiosis is extremely uncommon. Extra-nasal manifestations of rhinosporidiosis are relatively uncommon in clinical practice. Tonsillar rhinosporidiosis is extremely rare and often confused with oropharyngeal tumors. The mainstay of treatment of rhinosporidiosis is surgical excision by coblation, laser, or electric diathermy. Here, we report a 32-year-old man presented with a red, polypoidal mass of the palatine tonsil and bleeding occasionally and the diagnosis of rhinosporidiosis was confirmed by histopathological examination. The mass was completely removed along with the tonsil by coblation technique and the base was coagulated under general anesthesia. Hence, the possibility of this atypical site of rhinosporidiosis should be included in the clinical differential diagnosis of any pinkish mass originating from the palatine tonsil, particularly in the endemic area. [ABSTRACT FROM AUTHOR]

Nasal rhinosporidiosis refers to a rare chronic granulomatous disease caused by Rhinosporidium seeberi. It affects the mucous membrane of sites such as nasopharynx, conjunctiva and palate. Inverted papillomas are relatively rare and are benign epithelial tumors of the nasal cavity that are locally aggressive, exhibit recurrence tendency and malignant transformation. Both entities are very rare in our setting and this is perhaps the first documented case in Tanzania. The patient was a 7-year old boy with a 1-year history of left-sided nasal obstruction and intermittent epistaxis for 6 months. He had no history of cheek swelling, pain or numbness, loss or loosening of teeth or alveolar ridge fullness. There were no ophthalmological, otological or neurological complaints reported. Endoscopic excision of the nasal mass was done and histopathological analysis confirmed co-existence of rhinosporidiosis and inverted papilloma. Postoperatively, the patient was kept on oral dapsone at a dose of 50 mg/day for 6-months and with no residual disease recurrence noted after 6-months follow up. The patient underwent endoscopic excision of the nasal mass and histopathological analysis confirmed co-existence of rhinosporidiosis and inverted papilloma. Postoperatively, the patient was kept on oral dapsone at a dose of 50 mg/day for 6-months and with no residual disease recurrence noted after 6-months of follow up. Nasal rhinosporidiosis and inverted papilloma lesions may resemble the routinely encountered nasal polyps thus important for both clinicians and pathologists to have a high index of suspicion when managing patients with nasal masses even from non-endemic areas. • Nasal rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi • Rhinosporidiosis affects mucous membrane of nasopharynx, conjunctiva and palate. • Inverted papillomas are relatively rare, benign tumors of the nasal cavity • Inverted papillomas are locally aggressive, have recurrence rate in 14-78% of cases and undergo malignant transformation. • Transnasal endoscopic resection remains to be the treatment of choice for rhinosporidiosis and inverted papilloma [ABSTRACT FROM AUTHOR]

Rhinosporidiosis is a granulomatous disease with a chronic course, the etiological agent being Rhinosporidium seeberi which usually causes the development of localized lesion in the mucosa of the nose, conjunctiva, and urethra. The disease is prevalent in South India and Sri Lanka although case reports are evident from many parts of the world like Europe, America, and Africa. In the present study, we are reporting a case of rhinosporidiosis elaborating its clinical features, diagnostic modalities, and treatment. Since R.seeberi is not a successfully cultivable organism, in vitro susceptibility of drugs remains a concern. The main focus of the present study is on molecular detection of R. seeberi which can be helpful in the future for early diagnosis and prompt treatment of such cases.

Abstract Background Oculosporidiosis (ocular rhinosporidiosis) accounts for 15% of cases of rhinosporidiosis, which is a chronic granulomatous disease and is endemic in India and Sri Lanka. In Brazil, the climatic and hydrographic similarities to these endemic areas and the presence of riverside populations contributes to an increase in the incidence of rhinosporidiosis particularly in the State of Maranhão. This study, therefore, aimed to identify the number of diagnosed cases of oculosporidiosis and describe its the clinical epidemiology, laboratory, histopathology, and therapeutic characteristics. Methods The study is descriptive, observational, and cross-sectional, and reports the prevalence and clinical epidemiological characteristics of oculosporidiosis in the State of Maranhão, Brazil. A retrospective analysis of the paper and electronic records for a period from 1999 to 2017 was conducted in the University Hospital of Federal University of Maranhão (HU-UFMA), located in the northeastern region of Brazil. Results Thirty patients were diagnosed with rhinosporidiosis, eight of them had oculosporidiosis and seven of these met the criteria to be included in the study. Of the cases (23.3% of all 30), five were men (71.4%) and two women (28.5%), with an average age of 16.4 ± 15.6 years. In terms of race, four patients (57.1%) declared themselves white and three (42.9%) as brown. The north of the state, the mesoregion, had the most diagnosed cases accounting for 57.1% of the total. Left eye was the most affected site, reported in six patients (85.7%), while the conjunctiva was affected in all patients. Rhinosporidiosis and papilloma were the predominant diagnostic hypotheses (28.5 and 28.5%, respectively), followed by chronic scleritis, granuloma, and chalazion (14.25, 14.25, and 14.25%, respectively). All these cases were treated with lesion excision, and only two patients (28.5%) progressed with recurrence. Conclusion It was verified that there was a male predominance, with only one eye reported as an infected site, with no bilateral involvement. The younger age group (between 1 and 2 years of age) was more affected by oculosporidiosis, and histopathological examination was necessary for a conclusive diagnosis.

Purpose: To describe the outcome of external dacryocystorhinostomy (DCR) as a suitable alternative to dacryocystectomy (DCT) in cases of isolated lacrimal sac rhinosporidiosis. Methods: This was a retrospective, interventional case series. Institutional review board approval was obtained for the study. The chart review of 13 patients who underwent external DCR surgery for isolated lacrimal sac rhinosporidiosis between July 2012 and May 2018 was performed. Demographic details, clinical presentation, preoperative and intraoperative findings, surgical technique used, postoperative management, surgical outcome and duration of follow up were reviewed for each patient. Results: Thirteen patients were included in the study. Nine (69.2%) were male and four (30.8%) were female. The mean age was 22.1 years (range: 8–46 years). Involvement was unilateral in all cases. The commonest presenting complaint was epiphora with discharge seen in 10 cases (76.9%). An intrasac granuloma was grossly identified intraoperatively in 12 out of the 13 patients. Mean follow up was 26.9 months (range: 1.5–68 months). Till the last follow up, all cases were symptom free and did not have any evidence of recurrence of infection. Conclusion: From this series of cases reported by the authors, external DCR with appropriate precautions to prevent recurrence appears to be a suitable alternative to conventional DCT with excellent long-term outcomes without disease recurrence.

A 17-year-old male patient presented with cellulitis and mass in the eye noticed approximately 3 months back. The mass was about 1 cm in size and situated at the limbus. All preoperative routine investigations were normal. Surgical exploration revealed a sub-conjunctival cystic mass near the lateral rectus muscle about 1 cm in diameter; the mass was excised. Gross pathological examination revealed a thin-walled cystic mass. There was a hard nodule in the center. Microscopy revealed a wall of cysticercosis. Scolex was also seen. Surrounding tissue revealed sparse acute and chronic inflammatory cells. The case was confirmed by CDC, Atlanta, and was also included in their departmental presentation as an interesting case. A 60-year-old lady presented with complaints of itching over the forehead and right eye for 5 days. She was prescribed steroid eyedrops and antihistaminics. The itching aggravated with eyedrops along with watering and foreign body sensation. On revisit, the ophthalmologist noticed a worm in the right upper subconjunctival space. The worm was carefully removed in toto and sent to the laboratory for identification. The worm was thin, cylindrical, 8–10 cm long and white in color. After microscopic and gross examination of the worm, it was identified as Dirofilaria spp. CDC (Atlanta) confirmed the diagnosis of Dirofilaria. The patient was treated with antihistaminics and was relieved of symptoms without recurrence. A 45-year-old male patient had a painless mass in the eye for the last 3 months. He had no systemic illness. He gave a history of swimming pool use during that time. The mass was excised and submitted for histopathology. Numerous globular cysts representing thick-walled sporangia containing numerous spores diagnostic of Rhinosporidiosis were seen.

Rhinosporidiosis is a chronic infection of the mucous membrane caused by the Rhinosporiduim seeberi, which infects through transepithelial penetration. Although described worldwide, this entity is mostly found in the western hemisphere, afflicting young people, predominantly males, associated in many cases with recreational or professional contact with bath in ponds, rivers, or stagnant waters. The clinical features are varied depending on the affected membrane, in some cases mimicking other diseases postponing the correct diagnosis. Although nasal obstruction and epistaxis are the common clinical presentations in sinonasal rhinosporidiosis, patients with epiphora without a nasal mass often challenge the diagnosis. In the present case, we have documented a case of isolated lacrimal sac rhinosporidiosis masquerading as chronic dacryocystitis, which was successfully managed by endoscopic excision, accompanied by a literature review.

Rhinosporidiosis, a chronic inflammatory disease, which is caused by the aquatic microorganism Rhinosporidium seeberi, is endemic in India and in many other regions of the tropics. It primarily infects mucocutaneous surfaces of nose, nasopharynx, and conjunctiva through transepithelial invasion. However, over the centuries, atypical involvement of other body parts, especially viscera, bone, subcutaneous layers, genitals, the tracheobronchial tree, and even the skull has been, though rarely, reported. This chronic granulomatous infection is notorious for its propensity for recurrence following autoinoculation and poor response to most of the anti-microbials except dapsone. Surgical excision followed by cauterization remains the treatment of choice when an operation is feasible. We herein report a case of an immunocompetent person with primary disseminated dermato-pulmonary rhinosporidiosis, which created significant diagnostic dilemma at the beginning, got complicated due to dapsone-induced direct anti-globulin test-positive autoimmune hemolytic anemia, and finally responded to prolonged multidrug therapy with liposomal amphotericin B, ketoconazole and cycloserine. This report establishes the importance of tissue diagnosis in rhinosporidiosis and even, in resource-poor set-ups, a simple histopathological diagnosis can promote an early and affordable accurate diagnosis, and subsequently, a proper therapeutic intervention.

Rhinosporidiosis is a chronic granulomatous infection of the nose and nasopharynx. It is endemic in South Asia and commonly affects males in their second to fourth decades of life. Majority of the cases are found in the upper respiratory tract such as anterior nares, nasal cavity, inferior turbinate, nasal septum, floor, and nasopharynx. Although nose or nasopharynx is the most common location for rhinosporidiosis, it can also involve the skin, parotid duct, oropharynx, and larynx. Here, we report the case of a 42-year-old male who presented with extensive rhinosporidiosis in both nasal cavities and nasopharynx along with involvement of the roof of the oral cavity through erosion of the hard palate. The mainstay of treatment is wide excision followed by electrocautery of the base which ablates the recurrence. The rhinosporidiosis mass from different sites of the attachment was completely excised along with cauterization of the base. The diagnosis was confirmed by histopathological report. [ABSTRACT FROM AUTHOR]

Rhinosporidiosis is one of the granulomatous diseases endemic in Asia, Africa, and Europe, with Southern India and Sri Lanka having the greatest prevalence rates. It is typically understood to affect the upper respiratory system. Involvement of the lungs beyond the trachea is infrequent as compared to the upper respiratory tract. We revealed an uncommon case of disseminated rhinosporidiosis in a diabetic patient, who initially presented with shortness of breath associated with cough and fever. Two months prior to these symptoms, he was having oral ulcer and dysphagia and, subsequently, loss of weight. Chest radiograph and CT thorax revealed military nodules with multiple suppurative neck and mediastinal lymphadenopathy and bilateral adrenal lesions. He was initially investigated for tuberculosis, metastatic malignancy, or lymphangitic carcinomatosis before a biopsy revealed Rhinosporidiosis. Hence, histopathological or laboratory evidence is frequently crucial to back up imaging concerns so the appropriate treatment can be given., Competing Interests: The authors declare that there is no conflict of interest., (© 2024 The Authors.)

We describe a classic case of nasal rhinosporidiosis in a woman who resided in Johannesburg, South Africa, but originated from a rural area in Eastern Cape Province. We confirmed histologic diagnosis using PCR testing and compared details with those from records on 17 other cases from South Africa.

Abstract Rhinosporidiosis is a chronic granulomatous infectious disease caused by Mesomycetozoea Rhinosporidium seeberi. This highly recurrent polypoid lesion has a predilection for the nose and nasopharynx, although other organ systems may be affected. Involvement of the tracheobronchial tree is very rare, and poses a challenge for diagnosis and management. In this report, we present a 30‐year‐old man with a history of recurrent nasal polyp who presented with cough, shortness of breath, haemoptysis, and a radiological feature of right lung collapse on imaging. He was diagnosed with rhinosporidiosis based on histopathological examination of bronchoscopic biopsy specimen taken from the right principal bronchial mass. Shortly after hospitalization, he developed acute respiratory distress requiring emergency bronchoscopic intervention. A pinkish mulberry‐like tracheal and right bronchial mass was removed endoscopically with cauterization of the base of the lesion. On long‐term follow‐up, the patient was free of symptoms without recurrence of airway disease.

In our day to day ENT practice we commonly come across diseases involving the larynx, the oral cavity and the paranasal sinuses. These range from inflammatory disorders to benign and malignant neoplasms. Carcinomas involving the head and neck region are most commonly squamous cell carcinoma. However, a small proportion of cases present with other variants of carcinoma or infective pathology uncommon for the site. In this study we present three rare cases encountered in the out-patient department, namely, Primary Malignant Melanoma of the larynx, Neuroendocrine Tumor of the nose and paranasal sinuses and Rhinosporidiosis of cheek.

Rhinosporidiosis is a chronic granulomatous infectious disease that predominantly affects the mucosal membranes of the nose and nasopharynx. The disease is caused by Rhinosporidium seeberi, an eukaryotic pathogen with distinct geographical distribution particularly in tropical and subtropical areas acquired mainly through aquatic exposure.We report a case of a young Nepalese male who presented with recurrent right nasopharyngeal mass where surgical excision and histopathological examination confirmed the diagnosis following distinct pathognomonic findings. There is no optimal effective management of the disease and surgical excision coupled with cauterization to prevent recurrence is the recommended best option since medical treatment alone is ineffective. The clinical presentation, assessment and management options are reviewed.

Introduction: Rhinosporidiosis is a chronic mucocutaneous infection caused by Rhinosporidium seeberi, which mainly affects the mucus membranes of the nose, oropharynx, skin, eyes, and genital mucosa. The purpose of this case report was to illustrate the importance of clinicians in understanding the unusual incidence of this fungal infection, clinical presentation, treatment modalities, and recurrence rate. Observations: A clinical case report showed rare occurrence of rhinosporidiosis in the lower third of the face. The lesion was surgically excised by electrocauterization at its base. Commentaries: The patient showed no signs of recurrence even after 3 years of follow-up. Further research should be carried out to analyze the role of genetic predisposition in causing zoonotic infection. Conclusion: Rhinosporidiosis should also be considered as the differential diagnosis when facial swelling is encountered.

In our day to day ENT practice we commonly come across diseases involving the larynx, the oral cavity and the paranasal sinuses. These range from inflammatory disorders to benign and malignant neoplasms. Carcinomas involving the head and neck region are most commonly squamous cell carcinoma. However, a small proportion of cases present with other variants of carcinoma or infective pathology uncommon for the site. In this study we present three rare cases encountered in the out-patient department, namely, Primary Malignant Melanoma of the larynx, Neuroendocrine Tumor of the nose and paranasal sinuses and Rhinosporidiosis of cheek.

Abstract Background Rhinosporidiosis is a rare chronic infection of the mucous membranes caused by the Rhinosporidium seeberi. Approximately 15% of cases of rhinosporidiosis are ocular, occurring mainly in the tarsal conjunctiva. There are only 11 cases of scleral melt with staphyloma formation associated with bulbar conjuctival oculosporidiosis and none of them was associated with partial regression of the scleral ectasia after a corneoscleral tectonic graft. Case presentation a 13-year-old girl with a progressively increasing black mass in the upper nasal part above the cornea of the left eye. The biomicroscopy revealed an oval, bluish mass measuring 10x10x5 mm with congestion of the overlying conjunctiva. Conjunctival biopsy showed sporoblasts of Rinosporidium seeberi. Treatment was conducted by conjunctival resection and tectonic corneoscleral graft (13x13mm) over the staphyloma. Within 1 year of follow-up the patient presented a partial staphyloma reduction, 9x9x2.5 mm, and the patch detached from the lesion. A novel surgical approach was done reducing the corneal patch and no recurrence was seen after 9 months. Conclusions This case is one of the largest anterior scleral staphylomas secondary to rhinosporidiosis described in the literature. Scleral anterior staphyloma partial regression is an unusual outcome after a tectonic corneoscleral graft. Infection resolution and graft covering of thinned area contributed to scleral reepithelization.

We report 4 recent cases of nasal rhinosporidiosis in Rwanda. All patients were boys or young men living in the same district (Gatsibo District, Eastern Province), suggesting a reservoir in the area. The recent reemergence of rhinosporidiosis in Rwanda might reflect increased availability of diagnostic services rather than emerging disease.