Rhinosporidiosis in Colombia: case series and literature review

Abstract

Rhinosporidiosis is a chronic granulomatous disease that affects mucosal surfaces. Its epidemiology and clinical presentation in Colombia are not well-known. We therefore reviewed all 58 reported cases between 1964 and 2015 to raise awareness among clinicians in a non-endemic area. Of the patients, 64% were male (median age = 15 years) and 57% had ocular and 43% nasal manifestations; there were no disseminated cases of the disease. All lesions were surgically removed.

Rhinosporidiosis in the Americas: A Systematic Review of Native Cases

“…The relative frequency of cases in these geographic areas is not surprising because most of the reported cases occur in ecosystems found throughout these countries: arid areas (precipitation < 200 mm) or tropical areas (average temperature > 24°C, altitude 0-1,000 m above sea level, and annual precipitation of 1,750-2,000 mm). 3,11,18,20 However, although 91% of cases did occur at low altitudes (< 1,000 m above sea level, median altitude of 134 m above sea level), only 67.3% of the cases occurred in geographic areas with median temperatures ³ 25°C. Based on circumstantial data, the presumed natural habitat of R. seeberi is stagnant or ground waters.…”

“…Based on circumstantial data, the presumed natural habitat of R. seeberi is stagnant or ground waters. 3,11,12 More convincing evidence of this association comes from an outbreak in Serbia, where 17 patients bathed during a holiday in the same lake and developed rhinosporidiosis. 21 In this review, 72.7% of the cases for whom this information was available reported exposure to free-flowing or stagnant water.…”

“…8,9,23 Nasal compromise is the most frequent clinical presentation reported in both Asian cohorts and in the Americas. 1,3,9,12 Patients with nasal involvement usually present with a slow disease course of nasal obstruction, tumor-like masses, or bleeding. 3,12,14 With the exception of predominant ocular involvement reported in an outbreak in Serbia and in Sri Lanka where the main exposure was to water bodies, 9,21 ocular involvement is reported only for 10-18% of the cases in geographic areas outside of the Americas; in contrast, 35% of patients in the Americas present with ocular involvement.…”

“…It had been classified as a sporozoan and as a fungus; however, it has been reclassified under a new clade of aquatic protistan parasites, Ichthyosporea (Mesomycetozoea), through molecular methods. [1][2][3][4][5][6] The presumed natural habitat of R. seeberi is stagnant water, and infection probably occurs through transepithelial penetration. The most common clinical presentation is that of polypoidal or vascularized masses, especially in the nasal cavity (70-75%) and in the eye (10-18%).…”

Rhinosporidiosis—Factors predicting disease recurrence

“…However, in arid areas where dust is thought to harbour the organism, infections occur commonly in the eye. 10 Pharyngeal rhinosporidiosis is rare and can develop as an extension of nasal or nasopharyngeal lesion or as an isolated lesion.…”