Recurrent Rhinosporidiosis

Abstract

Rhinosporidiosis is a rare, chronic granulomatous disease, caused by the parasite Rhinosporidium seeberi. While rare in the United Sates, the disease is prevalent in the Indian subcontinent; as such, increasing immigration from that region will change the prevalence of R. seeberi in the United States. We report a case of recurrent rhinosporidiosis in a Bangladeshian male affecting the nasopharynx. The patient is a 41-year-old male from Bangladesh, with a 20 pack year smoking history, who first presented to our office, 4 years ago, complaining of hoarseness and a feeling of a lump in his throat. His symptoms were progressive. He underwent surgical resection using combination of scapel and electrocautery. Pathology was consistent with rhinosporidiosis. He now presents, 4 years later, with similar complaints and a physical examination demonstrating a recurrent, flesh-like lesion. This time however, surgical excision was performed using the Harmonic scapel. Follow-up endoscopic evaluation 6 months after surgery showed no signs of a recurrent lesion. The mode of treatment for rhinosporidosis has widely been anecdotal without much literature. Wide local surgical electrocauterization is the treatment of choice with postoperative systematic dapsone that may be prescribed for up to 1 year. However, local recurrence remains a problem, likely secondary to auto-innoculation during the surgical trauma. Although rare in the United States, immigration from areas of the world where it exists increases the likelihood that the practicing head and neck specialist may encounter such disease entity in their practice. Familiarity with surgical and medical therapy will afford a more systematic approach for treating patients.




J Med Cases. 2014;5(2):58-61
doi: https://doi.org/10.14740/jmc1637w