Case of 27-year-old male patient with 3-month history of progressive obstruction and bleeding from nose.
A 27-year-old male patient presented to the otorhinolaryngology outpatient clinic with complaints of progressive obstruction and bleeding from his right naris which had been going on since 3 months.
On physical examination, a red, granular, pedunculated, nonpulsatile mass could be seen obstructing the nasal cavity. In addition, the mass bled on touch (Panel A). The patient’s history revealed that he would often bathe in the local pond. Treatment included excision of the mass and cauterisation of the base of the lesion. Histopathological analysis of the biopsied specimen revealed multiple thick-walled sporangia at different stages of maturation, surrounded by dense inflammation (Panel B, hematoxylin and eosin).
The findings were consistent with the diagnosis of rhinosporidiosis. Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi, aquatic prostitan parasite. The disease typically presents with a reddish, friable mucosal polyp that commonly involves the nasal cavity. In addition to this, the polyp bleeds on touch, as in this case. The disease is an endemic in India and Sri Lanka. However, the infection occurs in other parts of the works also, including Africa and South America. The patient had areas of recurrence in the nasopharynx at 8 months follow up. The polyps were removed.
References
Rhinosporidiosis https://www.nejm.org/doi/full/10.1056/NEJMicm1811820
