Laryngeal Rhinosporidiosis: Report of a Rare Case

Abstract

Extranasal man ifestations ofrhinosporidiosis are relati vely uneonun on. Laryngeal involv em ent is ex tretnely rare, as only 3 cases ha ve been previously reported. We describ e a newcase, which occ urred in a patient with coexisting nasal rhin osporidiosis who present ed with inspiratory stridot: Both lesions were cotnp letely excise d under ge neral anesthesia without the needfor preliminary tracheostomy.

Laryngeal rhinosporidiosis in a Belgian warmblood horse

“…As they bleed easily, this location of lesions is often associated with a history of nasal obstruction or epistaxis (Rahat and Sadiq, 2005). Several sites can be affected (Agarwal et al., 1959; Kameswaran, 1966; Pillai, 1974) but laryngeal involvement is extremely rare: in 2004, only four human cases were described (Kumar et al., 2004). In animals, the disease has been described in equidae, cattle, dogs, a cat and avian species (Lengfelder and Pospischil, 1980; Jimenez et al., 1986; Moses and Balachandran, 1987; Caniatti et al., 1998; Wallin et al., 2001; Leeming et al., 2007).…”

Rhinosporidiosis of the upper airways and trachea

“…4 Although rhinosporidiosis has been reported in the Americas, Europe, Africa and Asia, it is far more common in the tropics, with greatest prevalence seen in South India and Sri Lanka. 1,6,7 It may be transmitted by direct contact with the spores of R seeberi via dust or infected clothing, or through swimming in stagnant water contaminated with the spores. The organism has developed various mechanisms of immune evasion (i.e.…”

“…Other mucosal sites are involved infrequently, including the palpebral conjunctiva, oropharynx, nasopharynx, maxillary antrum, larynx, external ear canal, parotid duct and genitalia. 3,6,7 Oral and oropharyngeal lesions may interfere with breathing and/or eating. 6 Systemic dissemination to the trachea, lung, urethra, liver, genitalia, lacrimal sac and bone is very rare.…”

“…1,6,7 Rhinosporidium seeberi is easily identified in haematoxylin and eosin stained smears. Spores and sporangia are better demonstrated by periodic acid Schiff, Mayer's mucicarmine, Verhoff's vonGieson and Grocott Gomori methamine silver stains.…”

“…3,10 Medical treatment of rhinosporidiosis with dapsone may be effective, as it arrests the maturation of sporangia, accelerates their degeneration, increases the granulomatous response with fibrosis, and prevents recurrence by interfering with the folic acid metabolism of the organism. 1,4,7,10 …”