Rhinosporidiosis Rhinosporidiosis R. Seeberi (Life Cycle)

8/9/11 Rhinosporidiosis
  Chronic fungal infection of   Then thought to be a
Rhinosporidiosis
By Courtney Madden, Shalyn Russell
& Brittany Seman
the mucous membrane
that causes an
inflammatory polyps in
the nasal mucous
membranes or external
eye membranes
  Causative agent:
Rhinosporidium seeberi
water mold
  Recent molecular
techniques (2010) give
evidence of being an
aquatic protistan parasite
  Included in a new class
Mesomycetozoa
  Sometimes just referred
to as a “water mold”
  Taxonomy largely debated
  Originally thought to be a
protozoan
Rhinosporidium seeberi:
Geographic Distribution
  Most cases restricted to
Rhinosporidium seeberi:
Epidemiology & Pathogenesis
  Infections can target:
Indian subcontinent
  Endemic in India, Sri
  Skin
  Eyes (~10 % of cases)
  Nasal cavities (~70% of
  Other cases are
  Spread through body
Lanka, Africa and South
America
cases)
scattered worldwide
included some cases
out of the U.S.
(Image: http://emedicine.medscape.com/article/227734overview)
  Males effected 4
times more
frequently
  Occurs mostly in
ages 15-40
(rare & life threatening)
  Nasal Infections- after
swimming in stagnant
water
  Occurs in warm
climates
  Eye infections-dust or
  Water helps release
endospores
(Images: http://www.merinews.com/article/
indian-subcontinent-after-61-years/
139296.shtml)
air mainly in summer
(Image: http://www.stanford.edu/
class/ humbio103/ParaSites2002/
rhinosporidiosis)
R. Seeberi (Life Cycle)
  Starts as juvenile
sporangium (1)
  Grows into immature
biamellar sporangia (2,3)
  Maturation of endospores
(4a, 4b)
  Spores exiting mature
sporangium (5)
  Free endospore w/mucoid
material (6)
  Free electron body (7a)(Diagram: http://www.drtbalu.co.in/rhinosporidiosis.html)
http://
dermatology.cdlib.org/
111/case_presentations/
rhinosporidiosis/5.jpg
*infective form*
  Free electron dense body
(7b)
BIOL 4849: Medical Mycology
August 9, 2011
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August 9, 2011
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http://www.ijdvl.com/articles/2011/77/4/images/
ijdvl_2011_77_4_517_82391_u1.jpg
BIOL 4849: Medical Mycology
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August 9, 2011
Rhinosporidiosis (cont.)
  Treatment
  Surgical removal
  Electrodessication
  Dapsone is used
sometimes, but
does not resolve
the disease
  No known oral/
topical agents that
can control the
disease
http://oto.sagepub.com/content/124/1/121/
F1.small.gif
BIOL 4849: Medical Mycology
August 9, 2011
Case Report One
  32 year on male farmer
  No significant past medical history
  Reported non tender swelling over right
shoulder
  Radiograph Imaging and CT Scan
  Showed a destructive lesion associated with a
soft tissue mass
  Initial biopsy reported rhinosporidiosis
  Excision of a 17x11.5x9 cm tissue mass
and small portion of bone was performed
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BIOL 4849: Medical Mycology
  Prevention
  Use cleaned
ponds/water areas
for animals/
humans
  General hygiene,
clean showers
http://www.arquivosdeorl.org.br/
conteudo/imagesFORL/11-02-19-fig028/9/11
ing.gif
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Case Report One (cont.)
  Biopsy of the mass
showed solidcystic, yellowish
white lesions with
areas of necrosis
  H&E stains showed
R. seeberi
  No recurrance over
12 months
http://journals.ohiolink.edu/ejc/pdf.cgi/
Suryawanshi_Pallavi_Vishnu.pdf?
issn=03642348&issue=v40i0002&article=225_rit
tdcpcmabt
2 8/9/11 Case Report Two
  After a CT Scan and
  53 year old male
radiograph were done
patient was incorrectly
diagnosed with infective
arthritis of tuberculous
origin
  Presented with pain in
his right ankle and
multiple painless warts
on his upper lip and
forehead
amputation from the
knee down and
excision of the warts
right talus was soft and
collapsed
continuous for one year
10 years prior he had a
fungal infection causing
swelling in the chin the
had been excised
  Treatment was
  Surgery showed whole
  Ankle pain had been
  Medical history showed
Case Report Two (cont.)
http://www.josonline.org/pdf/v16i1p99.pdf
References
  Histopathological
testing provided
diagnosis of
rhinosporidiosis
http://www.josonline.org/pdf/v16i1p99.pdf
References (cont.)
  Arora, et al . "Epidemiology & Country Information." Standford.edu.
N.p., n.d. Web. 5 Aug 2011. <http://www.stanford.edu/class/
humbio103/ParaSites2002/rhinosporidiosis/>.
  "Rhinosporidiosis." DoctorFungus. N.p., n.d. Web. 5 Aug 2011.
<http://www.doctorfungus.org/mycoses/human/other/
thinosporidiosis.php>.
  Rivard, Robert, and Duane Hospenthal. "rhinosporidiosis." Medscape.
N.p., 22 Feb 2010. Web. 5 Aug 2011. <http://
www.emedicine.medscape.com>.
  Kumari R, Nath AK, Rajalakshmi R, et. al. Disseminated cutaneous
rhinosporidiosis: Varied morphological appearances on the skin.
Indian Journal of Dermatology, Venereology and Leprology 2009; 1:
68-71.
  Rhinosporidiosis. Medscape Reference. [Updated 2011 August 3].
Available from:
http://emedicine.medscape.com/article/227734-overview
  Ghosh A, Saha S, Srivastava A, Mishra S. Rhinosporidiosis – unusual
presentations. Indian J. Otolaryngol. Head Neck Surg. 2008; 60: 159-162.
  Survawanshi et al Rhinosporidiosis isolated to the dital clavicle: a rare
presentation clinicoradiologically mimicking a bone tumor. Skeletal
Radiology. (2011) 40:225–228. Available from: <
http://journals.ohiolink.edu/ejc/pdf.cgi/
Suryawanshi_Pallavi_Vishnu.pdf?
issn=03642348&issue=v40i0002&article=225_rittdcpcmabt>
  Amritanand el al Disseminated rhinosporidiosis destroying the talus: a
case report. Journal of Orthopedic Surgery. 2008;16(1):99-101.
Available from: <http://www.josonline.org/pdf/v16i1p99.pdf>
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