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Rhinosporidiosis

A 27-year-old man presented to the otorhinolaryngology clinic with a 3-month history of progressive obstruction and bleeding from the right nostril. Physical examination revealed a red, friable, pedunculated, non-pulsatile mass that occluded the right nasal cavity and bled upon touch (Figure A). The patient reported that he frequently swam in a local pond. The mass was excised, and the base of the lesion was cauterized. Histopathological examination revealed multiple thick-walled sporangia at various stages of maturation, surrounded by dense inflammation (Figure B, hematoxylin and eosin). A diagnosis of rhinosporidiosis was made.

Rhinosporidiosis is a chronic granulomatous disease caused by the aquatic protozoan parasite Rhinosporidium seeberi. Typical manifestations include a reddish, friable polyp of the mucous membrane, usually involving the nasal cavity, which bleeds profusely upon touch. The oropharynx, conjunctiva, re**um, and external genitalia may also be affected. The disease is endemic in India and Sri Lanka, though infection also occurs in other parts of the world, including Africa and South America.

At an 8-month follow-up, the patient had recurrent lesions in the nasopharynx that were removed.