Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2020.214
Autopsy and Case Reports
Clinical Case Report and Review

Rhinosporidiosis of the lacrimal sac masquerading as chronic dacryocystitis: a rare presentation

Pradeep Pradhan; Swagatika Samal

Downloads: 0
Views: 164

Abstract

ABSTRACT: Rhinosporidiosis is a chronic infection of the mucous membrane caused by the Rhinosporiduim seeberi, which infects through transepithelial penetration. Although described worldwide, this entity is mostly found in the western hemisphere, afflicting young people, predominantly males, associated in many cases with recreational or professional contact with bath in ponds, rivers, or stagnant waters. The clinical features are varied depending on the affected membrane, in some cases mimicking other diseases postponing the correct diagnosis. Although nasal obstruction and epistaxis are the common clinical presentations in sinonasal rhinosporidiosis, patients with epiphora without a nasal mass often challenge the diagnosis. In the present case, we have documented a case of isolated lacrimal sac rhinosporidiosis masquerading as chronic dacryocystitis, which was successfully managed by endoscopic excision, accompanied by a literature review.

Keywords

Lacrimal Apparatus Diseases, Eye Diseases, Rhinosporidiosis, Mesomycetozoea infections, Endemic Diseases

References

1 Kumari R, Laxmisha C, Thappa DM. Disseminated cutaneous rhinosporidiosis. Dermatol Online J. 2005;11(1):19. PMid:15748560.

2 Thappa DM, Venkatesan S, Sirka CS, Jaisankar TJ, Gopalkrishnan, Ratnakar C. Gopalkrishnan, Ratnakar C. Disseminated cutaneous rhinosporidiosis. J Dermatol. 1998;25(8):527-32. http://dx.doi.org/10.1111/j.1346-8138.1998.tb02449.x. PMid:9769599.

3 Gonazalez G, Viada J, Escalona A, Na’quira N. Nasal rhinosporidiosis - four cases relate literature review. Int Arch Otorhinolaryngol. 2007;11:428-9.

4 Herr RA, Ajello L, Taylor JW, Arseculeratne SN, Mendoza L. Phylogenetic analysis of Rhinosporidium Seeberi’s 18S Small-Subunit Ribosomal DNA groups this pathogen among members of the protoctistan mesomycetozoa clade. J Clin Microbiol. 1999;37(9):2750-4. http://dx.doi.org/10.1128/JCM.37.9.2750-2754.1999. PMid:10449446.

5 Karthikeyan P, Vijayasundaram S, Pulimoottil DT. A retrospective epidemiological study of rhinosporidiosis in a Rural Tertiary Care Centre in Pondicherry. J Clin Diagn Res. 2016;10(5):MC04-08. http://dx.doi.org/10.7860/JCDR/2016/17465.7788. PMid:27437252.

6 Morelli L, Polce M, Piscioli F, et al. Human nasal rhinosporidiosis: an Italian case report. Diagn Pathol. 2006;1(1):25.http://dx.doi.org/10.1186/1746-1596-1-25. PMid:16945122.

7 Kuriakose ET. Oculosporidiosis: rhinosporidiosis of the eye. Br J Ophthalmol. 1963;47(6):346-9. http://dx.doi.org/10.1136/bjo.47.6.346. PMid:14189701.

8 Pushker N, Kashyap S, Bajaj MS, et al. Primary lacrimal sac rhinosporidiosis with grossly dilated sac and nasolacrimal duct. Ophthal Plast Reconstr Surg. 2009;25(3):234-5. http://dx.doi.org/10.1097/IOP.0b013e3181a39495. PMid:19454941.

9 Shrestha SP, Hennig A, Parija SC. Prevalence of rhinosporidiosis of the eye and its adnexa in Nepal. Am J Trop Med Hyg. 1998;59(2):231-4. http://dx.doi.org/10.4269/ajtmh.1998.59.231. PMid:9715938.

10 Chowdhury RK, Behera S, Bhuyan D, Das G. Oculosporidiosis in a tertiary care hospital of western Orrisa, India: a case series. Indian J Ophthalmol. 2007;55(4):299-301. http://dx.doi.org/10.4103/0301-4738.33045. PMid:17595481.

11 Suseela V, Subramaniam KS. Rhinosporidiosis and the eyes. Indian J Ophthalmol. 1976;23(4):1-4. PMid:1031152.

12 Basu SK, Bain J, Maity K, et al. Rhinosporidiosis of lacrimal sac: an interesting case of orbital swelling. J Nat Sci Biol Med. 2016;7(1):98-101. http://dx.doi.org/10.4103/0976-9668.175102. PMid:27003980.

13 Ashworth JH. On RhinosporidiumSeeberi (Wernicke 1903), with special reference to its sporulation and affinities. Trans R Soc Edinb. 1923;53:30142.

14 Gupta N, Singla P, Pradhan B, Gurung U. Lacrimal sac rhinosporidiosis: case report and review of literature with a new grading system to optimize treatment. Saudi Journal of Ophthalmology. 2019;33(3):283-90. http://dx.doi.org/10.1016/j.sjopt.2019.05.002.

15 Suneer R, Sivasankari L. Clinical profile of rhinosporidiosis in a tertiary care centre of an endemic area. Int J Otorhinolaryngol Head Neck Surg. 2018;4(3):659-62. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20181382.

16 Prabhu MS, Irodi A, Khiangte HL, Rupa V, Naina P. Imaging features of rhinosporidiosis on contrast CT. Indian J Radiol Imaging. 2013;23(3):212-8. http://dx.doi.org/10.4103/0971-3026.120267. PMid:24347850.

17 Rajesh Raju G, Sandeep S. Lacrimal sac rhinosporidiosis and surgical management by transnasal endoscopic excision: a case series. Laryngoscope. 2018;128(12):2693-6. http://dx.doi.org/10.1002/lary.27322. PMid:30194840.

18 Girish N, Prathima. Rhinosporidiosis of lacrimal sac: a case report. Int Clin Pathol J. 2017;4(4):85-6. http://dx.doi.org/10.15406/icpjl.2017.04.00099.

19 Chakraborti C, Barua N, Chishti RK, Kumar S. A rare case of lacrimal sac diverticulum associated with rhinosporidiosis. J Clin Ophthalmol Res. 2017;5:97-9.

20 Jamison A, Crofts K, Roberts F, Gregory ME. Educational report: a case of lacrimal sac rhinosporidiosis. Orbit. 2016;35(5):254-7. http://dx.doi.org/10.1080/01676830.2016.1193529. PMid:27541939.

21 Mishra LK, Gupta S, Pradhan SK, Baisakh MR. Lacrimal sac rhinosporidiosis. Plast Aesthet Res. 2015;2(6):353-6. http://dx.doi.org/10.4103/2347-9264.169501.

22 Nuruddin M, Mudhar HS, Osmani M, Roy SR. Lacrimal sac rhinosporidiosis: clinical profile and surgical management by modified dacryocystorhinostomy. Orbit. 2014;33(1):29-32. http://dx.doi.org/10.3109/01676830.2013.844170. PMid:24195743.

23 Sah BP, Chettri ST, Si S, Kandel DR, Ir D. Lacrimal sac rhinosporidiosis: an unusual case report. Am J Med Case Rep. 2014;2(4):84-6. http://dx.doi.org/10.12691/ajmcr-2-4-4.

24 Guru RK, Pradhan DK. Rhinosporidiosis with special reference to extra nasal presentation. J Evol Med Dental Sci. 2014;3(22):6189-99. http://dx.doi.org/10.14260/jemds/2014/2721.

25 Mukherjee PK, Shukla IM, Deshpande M, Kher P. Rhinosporidiosis of the lacrimal sac. Indian J Ophthalmol. 1982;30:513.

26 Belliveau MJ, Strube YNJ, Dexter DF, Kratky V. Bloody tears from lacrimal sac rhinosporidiosis. Can J Ophthalmol. 2012;47(5):e23-4. http://dx.doi.org/10.1016/j.jcjo.2012.03.019. PMid:23036556.

27 Mithal C, Agarwal P, Mithal N. Ocular and adnexal rhinosporidiosis: the clinical profile and treatment outcomes in a tertiary eye care centre. Nepal J Ophthalmol. 2012;4(1):45-8. http://dx.doi.org/10.3126/nepjoph.v4i1.5849. PMid:22343995.

28 Rogers S, Waring D, Martin P. Recurrent lacrimal sac rhinosporidiosis involving the periocular subcutaneous tissues, nasolacrimal duct and nasopharynx. Orbit. 2012;31(5):358-60. http://dx.doi.org/10.3109/01676830.2012.700548. PMid:23030407.

29 Ghosh A, Saha S, Srivastava A, Mishra M. Rhinosporidiosisunusualpresentations. Indian J Otolaryngol Head Neck Surg. 2008;60(2):159-62. http://dx.doi.org/10.1007/s12070-008-0003-3. PMid:23120527.

30 Varshney S, Bist SS, Gupta P, Gupta N, Bhatia R. Lacrimal sac diverticulum due to rhinosporidiosis. Indian J Otolaryngol Head Neck Surg. 2007;59(4):353-6. http://dx.doi.org/10.1007/s12070-007-0100-8. PMid:23120472.

31 Ghorpade A, Gurumurthy J, Banerjee PK, Banerjee AK, Bhalla M, Ravindranath M. Oculosporidiosis presenting as an under-eye swelling. Indian J Dermatol Venereol Leprol. 2007;73(3):196-7. http://dx.doi.org/10.4103/0378-6323.32749. PMid:17558058.

32 Watve JK, Mane RS, Mohite AA, Patil BC. Lacrimal sac Rhinosporidiosis. Indian J Otolaryngol Head Neck Surg. 2006;58(4):399-400. http://dx.doi.org/10.1007/BF03049611. PMid:23120364.

33 Nerurkar NK, Bradoo RA, Joshi AA, Shah J, Tandon S. Lacrimal sac rhinosporidiosis: a case report. Am J Otolaryngol. 2004;25(6):423-5. http://dx.doi.org/10.1016/j.amjoto.2004.04.012. PMid:15547812.

34 Thakur SKD, Sah SP, Badhu BP. Oculosporidiosis in Eastern Nepal: a report of five cases. Southeast Asian J Trop Med Public Health. 2002;33(2):362-4. PMid:12236438.

35 Krishnan MM, Kawatra VK, Rao VA, Ratnakar C. Diverticulum of the lacrimal sac associated with rhinosporidiosis. Br J Ophthalmol. 1986;70(11):867-8. http://dx.doi.org/10.1136/bjo.70.11.867. PMid:3098278.

36 Suseela V, Subramaniam KS. Rhinosporidiosis and the eyes. Indian J Ophthalmol. 1975;23(4):1-4. PMid:1031152.

37 David SS, Sivaramasubrahmanyam P. Ocular rhinosporidiosis, a study of twenty one cases. Indian J Ophthalmol. 1973;21:204-7.

38 Bain J, Basu SK, Maity K, et al. Rhinosporidiosis of lacrimal sac: an interesting case of orbital swelling. J Nat Sci Biol Med. 2016;7(1):98-101. http://dx.doi.org/10.4103/0976-9668.175102. PMid:27003980.

39 Jain MR, Sahai R. Rhinosporidiosis of the lacrimal sac. Indian J Ophthalmol. 1974;22(3):29-30. PMid:4465292.

40 Sood NN, Rao SN. Rhinosporidium granuloma of the conjunctiva. Br J Ophthalmol. 1967;51(1):61-4. http://dx.doi.org/10.1136/bjo.51.1.61. PMid:6018553.

41 Gonazalez G, Viada J, Escalona A, Na’quira N. Nasal rhinosporidiosis - four cases relate literaturereview. Int Arch Otorhinolaryngol. 2007;11:428-9.

42 Karunaratne WA. The pathology of rhinosporidiosis. J Pathol Bacteriol. 1936;42(1):193-202. http://dx.doi.org/10.1002/path.1700420121.
 


Submitted date:
05/29/2020

Accepted date:
07/21/2020

Publication date:
01/28/2021

601315e90e8825c130045c65 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections