877. Disseminated Cutaneous and subcutaneous Rhinosporidiosis - a case series study from South India
Session: Poster Abstract Session: Bone, Joint, and Soft Tissue Infection
Friday, October 19, 2012
Room: SDCC Poster Hall F-H
Posters
  • RHINOSPORIDIOSIS with logo .jpg (3.3 MB)
  • Background: Rhinosporidiosis is a chronic granulomatous disease caused by cynobacterium  Microcystis aeruginosa (previously though to be 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 2011. 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 9.5years. They presented with gradually increasing red colored swellings over the body. One patient had swellings at sites of surgical scars (panel A,B).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 immunosuppressive conditions.Reddish friable, fleshy lesions were noted in the nasal cavity and at other sites. One patient had subcutaneous swelling in the face and arms(panel D,E,F) and exophytic(panel C)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 (panel G,H).All were started on dapsone 100 mg daily for 6 months and surgical excision of the swellings was done in one patient. Patient who was treated with dapsone and surgical excision had complete cure at 1 year follow up whereas those who were treated only medically had recurrence of the disease.

    Conclusion: Rhinosporidiosis is an uncommon infection affecting the nasal mucosa and eyes which can rarely involve the skin and subcutaneous tissue. Cutaneous disease result from contiguous spread from mucosal lesion by autoinoculation or rarely by hematogenous dissemination.The treatment results of surgery combined with medical treatment are encouraging.

    Description: C:\Users\DRC\Desktop\RHINO IDSA1.jpg

    Teny Mathew John, MD, DNB, Internal Medicine, Government Medical College,Kottayam, Kottayam, India; Medicine Infectious Diseases, Hamad Medical Corporation, Doha, Qatar, Ceena Neena Jacob, M.D., 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 and Jerry Xavier, MBBS, Medicine, Govt.Medical College,Kottayam, Kottayam, India

    Disclosures:

    T. M. John, None

    C. N. Jacob, None

    A. Jacob, None

    A. M. George, None

    J. Xavier, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 17th with the exception of research findings presented at the IDWeek press conferences.