Rhinosporidiosis

Rhinosporidiosis is a chronic infective disorder caused by Rhinosporidium seeberi. It is characterized by polypoidal lesions that primarily affect the mucous membranes of the nose and nasopharynx. Other sites of the body can also be involved, including the eyes, ears, and skin. The disease is endemic in India and Sri Lanka, but cases have been reported worldwide.

Etiology

The causative agent of rhinosporidiosis is Rhinosporidium seeberi, a unique organism that has been difficult to classify. It was initially thought to be a fungus, but recent molecular studies suggest that it is a protistan parasite related to the fish parasites in the class Mesomycetozoea.

Clinical Features

The disease presents as painless, polypoidal, friable masses that are pink to red in color. The lesions are often pedunculated and have a characteristic "strawberry-like" appearance due to the presence of numerous white dots on the surface, which represent the sporangia of the organism. The most common site of involvement is the nasal mucosa, followed by the nasopharynx, oropharynx, and conjunctiva. Other sites such as the skin, bones, and genitalia can also be involved, but this is rare.

Diagnosis

The diagnosis of rhinosporidiosis is made by clinical examination and confirmed by histopathological examination of the excised lesion. The characteristic finding is the presence of numerous mature and immature sporangia in the subepithelial tissue.

Treatment

The mainstay of treatment is surgical excision of the lesion. Recurrence is common, and regular follow-up is necessary. Medical treatment with dapsone has been tried with variable success.

Epidemiology

Rhinosporidiosis is endemic in India and Sri Lanka, but cases have been reported from many parts of the world. The disease affects both humans and animals, and transmission is thought to occur through contact with spores in water or dust.

References

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