Nasal Rhinosporidiosis in a Nigerian Child

Rhinosporidiosis is a rare chronic granulomatous infectious disease caused by Rhinosporidium seeberi and it usually presents as a granulose growth, most often in the nasal cavity or the area around the eye. This disease can be transmitted by direct contact with spores through dust, infected clothing and swimming in stagnant water. It is mainly endemic in India, Srilanka, Bangladesh; and sporadic cases have been reported from United States of America, Italy Brazil, Argentina and Africa.

Based on some literature research, it can be found that few cases of nasal rhinosporidiosis have been reported in Nigeria. So in this paper, the authors reported a rare case of nasal rhinosporidiosis in a 13-year-old male patient from Sokoto, North Western Nigeria and aimed to caution otorhinolaryngologists to have a high index of suspicion of this emerging disease entity in the management of patient with nasal mass. The patient was presented at the ENT clinic of Usmanu Danfodiyo University Teaching Hospital with 15-month history of intermittent epistaxis and left nasal mass noticed one month before presenting. After entering in the hospital, he was examined clinically and there was a strawberry like, fleshy polypoidal mass arising from the septum on probing and filling the left nasal cavity with associated clear mucoid rhinorrhea. Hematologic investigations showed the patient’s packed cell volume to be 24% while the biochemical results were within normal limits. He was also negative to HIV I and II screening. Plain radiographs of the paranasal sinuses demonstrated a soft tissue shadow in the left nasal cavity but no bony or sinus involvement. Histopathology of the specimen showed numerous sporangium containing spores pathognomonic of rhinosporidiosis. Finally, the disease was confirmed. Then the authors made a discussion on this disease. 

In conclusion, rhinospridiosis is an unusual cause of nasal masses in our region and is probably a fungal disease. To the best of our knowledge, this is the first reported case in this region. This lesion largely mimics ordinary nasal polyp; therefore, it is an important possible differential diagnosis to be considered in our region when evaluating patients with nasal masses.

Article by Daniel Aliyu and Sadikku Mallami Sahabi, from Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

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