Document Type: Case Reports

Authors

1 Dept. of Pathology, North Bengal Medical College, Sushrutnagar, West Bengal University of Health Sciences, India

2 Dept. of Pathology, Pone University India, Kolkata, India

3 Dept. Of Pathology, Kolkata University, Kolkata, India

Abstract

Rhinosporidiosis is a granulomatous disorder caused by Rhinosporidium seeberi, an aquatic parasite. It spreads through contaminated water and soil. It frequently involves the nasal cavity and nasopharynx. Disseminated or systemic lesions are rare. A 56 year old man presented with multiple tumor like lesions all over the body in our cancer institute in April 2012. Fine needle aspiration cytology (FNAC) from the skin lesions revealed many sporangia and spores of R. seeberi. He had history of nasal mass being removed by excision and was immunocompetent. Histopathological examination and periodic acid Schiff (PAS) stain confirmed it to be disseminated rhinosporidiosis. His accessible lesions were excised with cautery and he was put on oral dapsone therapy. He did not show recurrence till six months of therapy. A common lesion with an uncommon presentation should not be missed which can increase the morbidity and even mortality in such a case.

Keywords

  1. Anoop TM, Rajany A, Deepa PS, Sangamithra P, Jayaprakash R. Disseminated cutaneous rhinosporidiosis.J R Coll Physicians Edinb 2008;38:123-5.
  2. Hay RJ, Ajello L. Topley and Wilson’s Microbiology and Microbial infection. Medical Mycology. 9 th ed.London: Hodder Arnold; 1998.  
  3. Thappa DM, Venkatesan S, Sirka CS, Jaishankar TJ, Gopalkrishnan, Ratnakar C. Disseminated cutaneous rhinosporidiosis. J Dermatol 1998;25 (8):527-32.
  4. Ashworth JH. On Rhinosporidium seeberi with special reference to its sporulation and affinities. Trans  Royal Soc Edinb 1923;53: 301-42.
  5. Herr RA, Anjello L, Taylor, Arsecularatne SN, Mendoza L. Phylogenetic analysis of Rhinosporidium Seeberi’s18S small-subunit ribosomal DNA groups this pathogen among members of this proctistan Mesomycetezoa clade. J Clin Microbiol 1999; 37(9):2750-4.
  6. Fredericks DN, Jolley JA, Lepp PW, Kosek JC, Relman DA. Rhinosporidium seeberi: A human pathogen from a novel group of aquatic protistan parasites. Emerg Infect Dis 2000; 6 (3):273-82.
  7. Moses JSShanmugham AKingsly NVijayan JCBalachandran CVenkateswaren, et al.Epidemiological survey of rhinosporidiosis in Kanyakumari district of Tamil Nadu. Mycopathologia 1988;101(3):177-9.
  8. Saha SN, Mondal AR, Bera SP, Das S, Banerjee AR. Rhinosporidial infection in West Bengal: a Calcutta based hospital study. Indian J Otolaryngol Head Neck Surg 2001; 53 (2)100-4.
  9. Elder D, Elenitsas R, Jaworsky C, Johnson B. Lever's Histopathology of the skin. 8th ed. Philadelphia: Lippincott Williams and Wilkins; 1997.
  10. Nayak S, Acharjya B, Devi B, Sahoo A, Singh N. Disseminated cutaneous rhinosporidiosis. Indian J DermatolVenereolLeprol2007; 73 (3):185-7.
  11. Tolat SN, Gokhale NR, Belgaumkar VA, Pradhan SN,Birud NR. Disseminated cutaneous rhinosporidiosis in an immunocompetent male. Indian J Dermatol Venerol Leprol2007;73 (5):343-5.
  12. Kumari R, Nath AK, Rajalaxmi R, Adityan B, Thappa DM. Disseminated cutaneous rhinosporodiosis: varied morphological appearances on the skin. Indian J Dermatol Venerol Leprol 2009; 75 (1):68-71.
  13. Rajam RV, Viswanathan GC. Rhinosporidiosis: A study with a report of a fatal case with systemic dissemination. Indian J Surg 1955; 17:269-98.  
  14. Job A, Venkateswaran S, Mathan M, Krisnaswami H, Raman R. Medical therapy of rhinosporidiosis with dapsone. J Laryngol Otol 1993;107 (9):809-12.