1276. Disseminated Cutaneous and Subcutaneous Rhinosporidiosis- A Case Series Study from Kerala,South India
Session: Poster Abstract Session: Travel/Tropical Medicine and Parasitology
Saturday, October 22, 2011
Room: Poster Hall B1

Background: Rhinosporidiosis is a chronic granulomatous disease caused by cynobacterium  Microcystis aeruginosa (previously thought to be caused by R. seeberi ).Though it occurs universally, rhinosporidiosis is endemic in South Asia, particularly  southern India and Sri Lanka. It commonly affects the mucous membrane but cutaneous lesions are rare and subcutaneous lesions are extremely rare.

Methods: A case series study done at a tertiary care hospital in Kerala, South India from December 2009 to November 2010 where patients with rhinosporidiosis were studied. Detailed clinical examination, routine blood investigations and skin biopsy were performed in each case.

Results: 3 cases of rhinosporidiosis were diagnosed. All were males with a mean age of 51.3 9.5 years. They presented with gradually increasing red colored swellings over the body including face, arms, abdomen and soles of feet. One patient had swellings at sites of surgical scars. There was no associated itching, pain or constitutional symptoms. They also had reddish friable intra nasal polypoidal mass with bleeding and a history of bathing in community ponds. There was no history of diabetes mellitus or any other immunosuppressive condition. On examination reddish friable, fleshy lesions were noted in the nasal cavity and at other sites. One patient had subcutaneous swelling in the face and arms and exophytic, crusted lesions in the face and abdomen. Routine investigations and retroviral status were unremarkable. Biopsy from the nasal mass and skin swellings showed sporangia with sporangiospores consistent with a diagnosis of rhinosporidiosis.  They were started on dapsone 100 mg daily for 6 months and surgical excision of the swellings were done in one patient. Response to treatment was poor and all had recurrence/ persistence of their disease.

Conclusion: Rhinosporidiosis is an uncommon infection affecting the nasal mucosa and eyes which can rarely involve the skin. Subcutaneous disease is still rare. Cutaneous disease result from contiguous spread from mucosal lesion by autoinoculation or rarely by hematogenous dissemination. The treatment results are disappointing.

 

 


Subject Category: T. Travel/tropical medicine and parasitology

Teny Mathew John, M.D., Internal Medicine, Government Medical College,Kottayam, Kottayam, India, Ceena Jacob, M.B.B.S., Dermatology, Government Medical College, Kottayam, India, Amith Jacob, M.B.B.S., Internal Medicine, Govt.Medical College, Kottayam, India, Amrutha Mary George, M.B.B.S., Internal Medicine, Government Medical College, Kottayam, India, Sadeep M.S., M.D., Dermatology and Venerology, Government Medical College,Kottayam, Kottayam, India and Sobhana Kumary, M.D., Dermatology and Venerology, Government Medical College,Kottayam,Kerala,India, Kottayam, India

Disclosures:

T. M. John, None

C. Jacob, None

A. Jacob, None

A. M. George, None

S. M.S., None

S. Kumary, None

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