Rhinosporidiosis was first reported in Argentina but it is prevalent in many countries [1] and is endemic to Sri Lanka and parts of India [2]. The condition is caused by Rhinosporidium seeberi which is difficult to isolate or grow in culture media [3]. It is transmitted during swimming in infected waters and enters the human body through mucosal or cutaneous abrasions [4]. It typically affects young male adults, especially divers, farmers and sand workers [2]. Female patients with Rhinosporidiosis are rarely encountered probably because they are less active outdoors in the affected areas [5].

Patients can present several years after the initial infection as the lesions are slow growing. The granulomas can be identified by their classical appearance - pedunculated or sessile, soft, polypoidal, strawberry shaped masses which can occur on the mucous membrane of the nose, throat, soft palate, nasopharynx, conjunctiva, nasolacrimal duct, lacrimal gland, larynx, rectum [6] and even genitalia [2] [4]. The nasal septum and inferior turbinates are the most common sites in the nose to be involved [4]. The oral cavity is rarely affected. Sexual partners of men with rhinosporidiosis of the urethral meatus have not been reported with rhinosporidiosis and therefore it is presumed to be non-contagious. The polypoidal lesions tend to recur despite treatment.

Cutaneous granulomas, as well as disseminated forms of the disease with brain involvement and even fatal cases, have been reported [4] [7].

• Chronic Infection

  Despite a chronic infection of 12 years' duration, there was no involvement of conjunctiva, nasal, or nasopharyngeal mucosa. [ncbi.nlm.nih.gov]

  Home British & World English rhinosporidiosis rhinosporidiosis noun Medicine Chronic infection of the nasal cavities or other parts of the body by the organism Rhinosporidium seeberi, occurring in humans and domestic animals, especially in South Asia [en.oxforddictionaries.com]

• Anemia

  PMID: 16533233 A case of primary disseminated rhinosporidiosis and dapsone-induced autoimmune hemolytic anemia: A therapeutic misadventure. Ghosh R, Mondal S, Roy D, Ray A, Mandal A, Benito-León J. Ghosh R, et al. [pubmed.ncbi.nlm.nih.gov]

  Patient Management As mentioned above, anemia does not seem to be caused by rhinosporidiosis. Recurrence can occur at any time so there is no need for regular follow up. [dermatologyadvisor.com]

  Hematological examination showed moderate anemia (8.8 gm%) and all biochemical parameters were within normal range. Chest X-ray and ultrasonography of abdomen and pelvis showed no abnormality. Serological tests for HIV and syphilis were negative. [ijdvl.com]

• Candidiasis

  Candidiasis of the stomach. A Barium contrast study showed decreased peristalsis in the stomach, with rigidity and narrowing of the body and pylorus. [isradiology.org]

  tinea versicolor, fungal infections (for example histoplasmosis, coccidioidomycosis), tinea cruris, candidiasis, endo- or systemic, mycosis, mycosis endogenous, exogenous mycosis blastoderm, Kokzidioido-, chromomycosis, histoplasmosis, nocardiosis, [google.com]

• Weight Loss

  No history of cheek swelling or pain, excessive sneezing, tooth ache, eye symptoms, fever, cough, drenching night sweat or progressive weight loss were present. He was non-smoker, non-alcoholic with no history of hypertension, diabetes or asthma. [casereports.in]

• Dyspnea

  The patients may also complain of dysphagia and dyspnea when lesions high in the turbinates protrude from the nares or into the nasopharynx. Ocular rhinosporidiosis- The lesions involve the palpebral conjunctiva. [histopathology-india.net]

The workup of rhinosporidiosis involves a detailed history and examination findings of the characteristic polypoidal, strawberry shaped appearance of the friable mass covered with white dots [2]. There are no laboratory tests for diagnosing the condition.

The extent of rhinosporidiosis can be determined using computed tomography (CT) scans which show enhancing lesions of moderate to severe intensity [8].

Histological examination of the lesions under the microscope is necessary to confirm the diagnosis. Fungal stains like Gomori methenamine silver and periodic acid-Schiff, as well as standard hematoxylin and eosin stains and potassium hydroxide preparations, can help to view the organism in different stages. Aspirates from rhinosporidiosis granuloma can provide cytological evidence while its identity can be confirmed due to the electron dense bodies within its endospores [4]. It is important to differentiate these endospores from those of Coccidioides immitis.

Currently, enzyme-linked immunosorbent assay (ELISA) is not available for routine testing but is used for epidemiological studies [9] [10].

CONCLUSION: An effective treatment for R. seeberi-a eukaryote belonging to the class Mesomycetozoea-is still elusive. Copyright © 2016. Published by Elsevier Ltd. [ncbi.nlm.nih.gov]

Its mainstay of treatment is surgery. [parjournal.net]

Well-organized Major Infectious Diseases chapters break down content by etiologic agent and epidemiology, clinical signs and their pathophysiology, physical examination findings, diagnosis, treatment and prognosis, immunity, prevention, and public health [books.google.de]

Prognosis is excellent, but recurrence is not unusual Keywords Computed tomography scan, lacrimal sac, Rhinosporidium seeberi, rhinosporidiosis Introduction Rhinosporidiosis is a chronic granulomatous disease affecting the mucous membrane primarily. [parjournal.net]

There are no antifungals or antimicrobials that interfere with the prognosis, but we suggest the prolonged use of Dapsone (100 mg/day for several months) may help prevent the disease recurrences (1,2,4). [arquivosdeorl.org.br]

The patient was counselled for ray amputation and prognosis discussed at length. A racket shaped incision was made and wide margin excision was carried out. [ijoonline.com]

Well-organized Major Infectious Diseases chapters break down content by etiologic agent and epidemiology, clinical signs and their pathophysiology, physical examination findings, diagnosis, treatment and prognosis, immunity, prevention, and public health [books.google.de]

[…] revealed no retinal abnormalities unlike in previous cases reported from Sri Lanka; c) atypical histopathology that resulted in an initial mis-diagnosis of chronic inflammation with mucus cysts and a missed diagnosis of rhinosporidiosis; the rhinosporidial etiology [dovepress.com]

Abstract Rhinosporidiosis is a chronic granulomatous disorder of infective etiology and it frequently affects the nasal cavity and nasopharynx. [e-ijd.org]

Causes: The etiologic agent of rhinosporidiosis, R seeberi, has traditionally been considered a fungus. [easymbbs.org]

Abstract One hundred forty-three cases of rhinosporidiosis, confirmed by smear or biopsy, treated in two major General Hospitals in Sri Lanka over a 14 year period (1995-2009) were analyzed in regard to their epidemiological, clinical, clinicopathological [ncbi.nlm.nih.gov]

Comprehensive Approach to Infections in Dermatology is a guide to all types of skin infection, with detailed information on epidemiology, presentation, diagnosis and management. [books.google.de]

Socio-demographic Correlates of Rhinosporidiosis: A Hospital-Based Epidemiologic Study in Purulia, India. Indian J Otolaryngol Head Neck Surg. 2017 Mar. 69 (1):108-112. [Medline]. [emedicine.com]

The epidemiological features, clinical presentations and histopathology were similar to those in other series. The antirhinosporidial antibody (mean) titers were IgM--142.1 and IgG--178.5, compatible with rhinosporidiosis of long duration. [scienceopen.com]

Well-organized Major Infectious Diseases chapters break down content by etiologic agent and epidemiology, clinical signs and their pathophysiology, physical examination findings, diagnosis, treatment and prognosis, immunity, prevention, and public health [books.google.de]

Pathophysiology: Rhinosporidiosis is a granulomatous disease affecting the mucous membrane of nasopharynx, oropharynx, conjunctiva, rectum and external genitalia. [easymbbs.org]

Pathophysiology Rhinosporidiosis is caused by the organism R. seeberi. The taxonomy of this agent has always been controversial. Early researchers noticed similarities between rhinosporidiosis and some aquatic parasites. [dermatologyadvisor.com]

Pathophysiology Local infection from exposure to the organism appears to be implicated in the pathogenesis of R. seeberi, but thus far, it has not been possible to intentionally infect an animal model (2). [webeye.ophth.uiowa.edu]

The site of the excised mass should be cauterized to prevent recurrence. [ncbi.nlm.nih.gov]

In a concise and user-friendly format, it offers authoritative coverage of epidemiology, diagnosis, differential diagnosis, pathology, laboratory tests, management, and prevention for both common and rare conditions. [books.google.de]

1. Morelli L, Polce M, Piscioli F, et al. Human nasal rhinosporidiosis: an Italian case report, Diagn Pathol. 2006; 1:25
2. Das S, Kashyap B, Barua M, et al. Nasal rhinosporidiosis in humans: new interpretations and a review of the literature of this enigmatic disease.Med Mycol. 2011; 49(3): 311-315
3. Ahluwalia KB. New interpretations in rhinosporidiosis, enigmatic disease of the last nine decades. J Submicrosc Cytol Pathol. 1992;24: 109 -114
4. Arseculeratne SN. Recent advances in rhinosporidiosis and Rhinosporidium seeberi. Indian J Med Microbiol. 2002;20: 119 -131
5. Makannavar JH, Chavan SS. Rhinosporidiosis — a clinicopathological study of 34 cases. Indian J Pathol Microbiol. 2001; 44: 17 -21
6. Pal DK, Moulik D, Chowdhury MK. Genitourinary rhinosporidiosis, Indian J Urol. 2008; 24: 419 -421
7. Ho MS, Tay BK. Disseminated rhinosporidiosis. Ann Acad Med Singapore. 1986; 15: 80 -83
8. Prabhu SM, Irodi A, Khiangte HL, Rupa V, Naina P. Imaging features of rhinosporidiosis on contrast CT. Indian J Radiol Imaging. 2013 Jul; 23(3):212-8.
9. Arseculeratne SN, Sumathipala S, Eriyagama NB. Patterns of rhinosporidiosis in Sri Lanka: comparison with international data. Southeast Asian J Trop Med Public Health. 2010 Jan; 41(1):175-91.
10. Sudasinghe T, Rajapakse RP, Perera NA, Kumarasiri PV, Eriyagama NB, Arseculeratne SN. The regional sero-epidemiology of rhinosporidiosis in Sri Lankan humans and animals. Acta Trop. 2011 Oct-Nov; 120(1-2):72-81.