Nasal Rhinosporidiosis in a Nigerian Child: A Rare Clinical Entity

Abstract

Background: Rhinosporidiosis is a rare chronic granulomatous disease characterized by polypous lesion of the mucous membrane caused by rhinosporidium seeberi which predominantly affects the mucous membrane of the Naso-pharynx, conjuctiva and palate. Rhinosporidiosis can be easily misdiagnosed as a neoplastic disease, and hence, it is necessary to educate the public and medical community about this emerging disease entity in our region. Aim: To report a rare case of nasal rhinosporidiosis in a 13-year-old male patient from Sokoto, North Western Nigeria. Case Report: A 13-year-old male Quranic child from gwadabawa village in Sokoto State, North Western Nigeria, whose parents are rice farmers, presented in the ENT clinic of Usmanu Danfodiyo University Teaching Hospital with 15-month history of intermittent epistaxis and left nasal mass noticed one month before presenting. He was examined clinically and a pinkish polypoidal mass arising from the septum and filling the left nasal cavity was seen. He subsequently had a biopsy of the mass and histopathological examination with special histochemical staining, which confirmed rhinosporidiosis. Conclusion: Rhinospridiosis is an unusual cause of nasal masses in our region and is probably a fungal disease. To the best of our knowledge, this is the first reported case in this region. This lesion largely mimics ordinary nasal polyp; therefore, it is an important possible differential diagnosis to be considered in our region when evaluating patients with nasal masses.

Nasal rhinosporidiosis masquerading as pyogenic granuloma in a pediatric patient at a Zonal Referral Hospital in Central Tanzania: Case report

“…Rhinosporidiosis tends to occur in human beings and in animals and is more common in hot tropical climates though highly endemic in India and Sri Lanka. [6][7][8][9] Sporadic pattern for the disease has been reported in other parts of the world such as Argentina, Brazil and Africa. 9 In terms of race and sex predilection, there is no racial predominance and males are more affected than females, especially those aged 15-40 years with male to female ratio being 4:1.…”

“…7,8,12,13 However, the disease remains to be very rare in our country; yet, there are some countries that have reported several cases including Nigeria. 8 The diagnosis of nasal rhinosporidiosis is established by observing the characteristics of the causative organisms in nasal tissue biopsies like sporangia that may be at variable stages of maturation. Since it presents like a polypoidal mass in the nasal cavity, it mimics other diseases presenting with nasal masses; 5,14-16 thus, a high index of suspicion by clinicians is of importance in the management of patients with nasal masses in the era of this emerging disease entity.…”

“…In terms of race and sex predilection, there is no racial predominance and males are more affected than females, especially those aged 15–40 years with male to female ratio being 4:1 2,10,11 . Rhinosporidiosis may be transmitted by direct contact with spores through dust, infected clothing, and swimming in stagnant water 7,8,12,13 . However, the disease remains to be very rare in our country; yet, there are some countries that have reported several cases including Nigeria 8 .…”

“…The disease predominantly affects the mucous membrane of the nose, nasopharynx, and conjunctiva. Rhinosporidiosis tends to occur in human beings and in animals and is more common in hot tropical climates though highly endemic in India and Sri Lanka 6–9 . Sporadic pattern for the disease has been reported in other parts of the world such as Argentina, Brazil and Africa 9 …”

Rhinosporidiosis- A retrospection

“…[4][5][6] Males are commonly affected although there is no racial predilection. 7,8 Four common varieties have been described: nasal, ocular, cutaneous and disseminated. Nasal lesions are more common and is usually seen on the inferior turbinates, septum and floor of nasal cavity.…”