Rhinosporidium granuloma of the conjunctiva.

Abstract

THIS case of Rhinosporidium granuloma in the fornix of the right conjunctival sac is the first to be reported from Pondicherry, India. Case Report A Hindu boy aged 12 years came to the Ophthalmic Outpatient Clinic of the General Hospital, Pondicherry, on February 9, 1965, with a mass in the upper part of the right eye, which his parents had noticed only a few days previously. There was no history of lacrimation or photophobia and no obvious cutaneous lesions or lymphadenopathy. The past, personal, and family histories were not significant. Examination.-There was a slight bulge in the middle of the right upper lid. There was no evidence of purulent discharge, but a mild degree of redness involving the superior fornix, and the upper lid was just elevated from the bulbar conjunctiva. The mass was moderately firm on palpation, there was no tenderness. On everting the upper lid, a brownish mass 5 x 3 x 3 mm. covered by tiny yellowish-white specks was seen lying in the upper part of the conjunctival sac. It was pedunculated, attached to the superior fornix slightly nasal to the mid-line, and moved freely with the conjunctiva. There was no evidence of ulceration or induration. Manipulation did not cause bleeding. The left eye was normal in all respects. The intra-ocular tensions, lacrimal sacs, corneae, and fundi were normal in both eyes. Treatment.-Under surface anaesthesia (Anethaine drops) the mass was excised at its stalk. Result.-The patient has not returned for follow-up examination. Histopathological Report.-The section consists of spores and sporangia of Rhinosporidium seeberi with diffuse lymphocytic, monocytic, and plasma cell infiltration of oedematous fibrous connective tissue stroma covered by stratified squamous epithelium, showing moderate hyperplasia in places. DIAGNOSIS-Rhinosporidium granuloma (Fig. 1).

Prevalence of rhinosporidiosis of the eye and its adnexa in Nepal.

“…The conjunctiva are the commonest sites of infection but the lacrimal duct, lid, and sclera may also be affected by ocular rhinosporidiosis. 8 In this study, the majority of the infections were confined to the conjunctiva and only six cases were in the lacrimal sac. No other sites in the eye were involved.…”

Atypical Presentations of Rhinosporidiosis: A Clinical Dilemma?

“…Macroscopically, the typical lesion of Rhinosporidiosis is fleshy, vascular, polypoidal and granulomatous, studded with grayish white dots, present on surface of lesion [8]. On histopathology, large round chitinous structure filled with endospores are seen [9].…”

Ocular and adnexal rhinosporidiosis : the clinical profile and treatment outcomes in a tertiary eye care centre

“…Ocular rhinosporidiosis is a disease of tropical climate and usually suspected in children with a history of bathing in local ponds/river water presenting with conjunctival polyp and chronic dacryocystitis (Kuriakose et al, 1963). The conjunctiva is the commonest site of infection but the lacrimal gland, lid and sclera may also be affected by ocular rhinosporidiosis (Sood and Rao, 1967). Most of the lesions are vascular and they bleed on touch.…”

“…The treatment of choice is complete surgical excision of the mass resulting in a very good postoperative outcome (figure2, figure 3). For cases involving the lacrimal sac dacrocystectomy is recommended (Sood and Rao, 1967). During dacrocystectomy care should be taken to avoid spilling the spores as well as complete excision of intact sac thereby minimizing the recurrence rates.…”