What Is Rhinosporidiosis?

Rhinosporidiosis is a benign, chronic granulomatous infection that mainly invades the nose and nasal mucosa caused by Seeber rhinosporium. The disease is prevalent in the tropics and subtropics. More than 80% of the cases occur in India and Sri Lanka, and the rest are Brazil and Argentina in South America. The disease can occur in any gender and age. It is more common in children and young people, and it is more common in men. The male to female ratio is 4: 1. The disease is transmitted by water or dust and is very contagious. The most common infections are the nasal and nasopharynx, eyes, and eye appendages. Rarely, the urethra, larynx, parotid duct, tracheobronchial, vagina, penis, anus, skin, and bones are also found in peritoneal effusion. Sporidiosis is extremely rare.

Basic Information

English name: rhinosporidiosis
Visiting department: Otorhinolaryngology-Head and Neck Surgery
Multiple groups: More common in children and young people, more common in men
Common locations: Nose

Common causes: Caused by Seeber rhinosporium
Common symptoms: Warts, mucus cysts, ear polyps, condyloma acuminatum, intestinal polyps, etc.
Contagious: Have
way for spreading: Spread by water or dust

Causes of Rhinosporidiosis

The Seeber rhinosporum system classification belongs to the phylum Sphaerotheca of chromista. It is located between fungi and animal branches in the classification of animals and plants and has not been successfully cultivated. It is found in lakes, ponds, and soil. Some animals, such as horses and cattle, are storage hosts for the bacteria and can be transmitted to humans.

Clinical manifestations of rhinosporidiosis

The disease can be seen in all age groups, more common in children and young people, more men than women, the most common nasal disease. Initially papillary, the surface shrinks like warts, gradually increases, the base is pedicled or tumor-like, and there is accumulation of mucus in the tumor, such as mucus cysts. When it occurs in the ear canal, it is like ear polyps; when it occurs in the penis, anus, and vagina, it is like genital warts; when it occurs in the rectum, it is like intestinal polyps. It can spread to the renal blood vessels, urine, peritoneal effusion, and internal organs through blood, but it is very rare.

Rhinosporidiosis

Histopathology: A biopsy of a polyp-like substance, the surface of which is a large sporangia with a grayish white spot, which can be covered with epidermis. HE staining shows that this type of sporangia with a diameter of 300 m is filled with countless endospores, sometimes broken or not. At various stages of maturation of sporangia, when endospores leave the sporangia and enter the tissue, it can cause neutrophil infiltration in surrounding tissues and tissue necrosis to form an abscess. Plasma cells and lymphocyte infiltration were also seen, with giant cells and blood vessel-rich granulomas and scars around the empty sporangia.

Differential diagnosis of rhinosporidiosis

It should be distinguished from fibrohemangioma, rhinosclerosis, papilloma, acute infectious polyps, granulomatous disease, tuberculosis and condyloma acuminatum. The pathogen should also be distinguished from another common rhinomycosis, coccidioidae, which has a similar stage of maturity, showing a large and thick-walled spherical structure that contains endospores, but the spheres are smaller and have a diameter of 20 to 80 m . Mature endospores are also small, only 2 to 5 m in size. Coccidia mucus staining was negative, and the culture was identifiable.

Rhinosporidiosis treatment

There is currently no specific medical treatment for rhinosporidiosis. General antibacterial and antimony treatments have not proven effective, and systemic application of antifungal drugs has certain effects. The only treatment that has proven effective is to treat the basal part after local surgical resection, such as freezing, electrocoagulation, or silver nitrate cautery, with the purpose of killing residual pathogens. Rhinosporidium is not sensitive to freezing and radiation, and the adverse reactions of radiation therapy are large, so it should not be promoted. It has been reported that surgical resection plus dapsone is effective in treating rhinosporidiosis. Avoid implanting spores to the trauma site during surgery.

Rhinosporidiosis prevention

1. Avoiding entering endemic areas is one of the effective measures to prevent the disease.

2. When working in the poultry-prone area of the endemic area, or through the area contaminated with the biological agent of the bacteria, and laboratory personnel who study the bacteria, they should wear masks or gas masks to prevent inhalation of nasal spores.

3. The development of a vaccine is the key to preventing the disease.