Generic selectors
Exact matches only
Search in title
Search in content
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter To Editor
2007:73:3;196-197
doi: 10.4103/0378-6323.32749
PMID: 17558058

Oculosporidiosis presenting as an under-eye swelling

A Ghorpade1 , J Gurumurthy2 , PK Banerjee2 , AK Banerjee3 , M Bhalla4 , M Ravindranath4
1 Department of Dermatology, Venereology and Leprosy, J.L.N Hospital & Research Center, Bhilai Steel Plant, Bhilai, India
2 Department of Otolaryngology, J.L.N Hospital & Research Center, Bhilai Steel Plant, Bhilai, India
3 Department of Ophthalmology, J.L.N Hospital & Research Center, Bhilai Steel Plant, Bhilai, India
4 Department of Pathology, J.L.N Hospital & Research Center, Bhilai Steel Plant, Bhilai, India

Correspondence Address:
A Ghorpade
Bhilai - 490006, Chhattisgarh
India
How to cite this article:
Ghorpade A, Gurumurthy J, Banerjee P K, Banerjee A K, Bhalla M, Ravindranath M. Oculosporidiosis presenting as an under-eye swelling. Indian J Dermatol Venereol Leprol 2007;73:196-197
Copyright: (C)2007 Indian Journal of Dermatology, Venereology, and Leprology
Figure 2: Histopathology showing multiple sporangia in various developmental stages, some with endospores (H and E, x100)
Figure 2: Histopathology showing multiple sporangia in various developmental stages, some with endospores (H and E, x100)
Figure 1: Skin colored swelling on the medial canthus of the right eye showing the orange peel appearance
Figure 1: Skin colored swelling on the medial canthus of the right eye showing the orange peel appearance

Sir,

Rhinosporidiosis is a chronic granulomatous infection of mucous membranes caused by Rhinosporidium seeberi , which presents usually to the otolaryngologist for vascular friable polyps. Several cases of rhinosporidiosis have been reported from Bhilai and neighborhood in the Chhattisgarh state. [1],[2],[3],[4] We came across a patient with ocular rhinosporidiosis who presented to the dermatology outpatient department with eyelid swelling. An 18-year-old male patient from a small village near Bhilai, was referred by an ophthalmologist for a gradually progressive swelling under the right eye of 8 months duration. He felt pain in the swelling since the last two weeks. A history of bathing regularly in the village pond with buffaloes was present. He had scanty bloody nasal discharge for 6 months, but had not consulted any doctor. There was no family history of similar complaints.

Cutaneous examination showed a diffuse, soft, skin colored, non-tender, fluctuant swelling over the right medial canthus, measuring about 4 cm x 3 cm in size [Figure - 1]. The overlying skin had an orange peel appearance albeit without any rise in local temperature. His systemic examination and blood count values were normal. FNAC from the lesion revealed multiple sporangia with endospores, pointing to the diagnosis of rhinosporidiosis. An otolaryngologist found a small pinkish mass in the right inferior meatus. The mass was reached under general anesthesia, through an incision in the right naso-optic sulcus. A pinkish mass with whitish small dots on its surface was found to occupy the lacrimal sac and project into the lacrimal duct. It was extracted from the upper opening of the duct and the part in the inferior meatus was excised separately from the right nasal chamber followed by electrocautery. Histopathology of the excised tissue revealed multiple sporangia with endospores [Figure - 2]. He was administered dapsone 100 mg daily orally, and has not had a recurrence since the last 8 months.

The causative organism of rhinosporidiosis has been now demonstrated to be an aquatic protistan parasite, and is currently included in a new class, the Mesomycetozoea, along with organisms that cause similar infections in amphibians and fish. It is the first known human pathogen from a novel clade of aquatic protistan parasites (Ichthyosporea). [5]

Ocular involvement may be seen in about 15% of cases of rhinosporidiosis. In a large series of oculosporidiosis, conjunctiva and lacrimal sac were found to be the most common structures involved. [6] The conjunctival lesions present as fleshy, pedunculated polyps studded with whitish dots representing mature sporangia. Isolated lacrimal sac rhinosporidiosis has been reported without nasal or conjunctival lesions. [7] In our patient, the lesions might have started in the nose and migrated up through the lacrimal duct into the lacrimal sac. FNAC is an important and easy diagnostic tool in this condition as shown in earlier reports. [1],[2],[3],[4] Meticulous excision with electric cautery remains the mainstay of treatment. Dapsone is known to cause fibrosis and shrinkage of the lesions and may prevent recurrences in some cases. Rhinsporidiosis localized only to the lacrimal sac and nasolacrimal duct, presenting with a swelling under the eye is uncommon. [7]

The term "dermosporidiosis" could be used to denote the cases of rhinosporidiosis presenting with predominant skin lesions, as has been recently suggested by the principal author. [ 3] If the skin lesion happens to be near the eye as in the present patient, a possibility of oculosporidiosis should be considered. Such a presentation may be puzzling for the treating physician unless this possibility is entertained, especially in the patients coming from an endemic region.

References
1.
Ramanan C, Ghorpade A. Giant cutaneous rhinosporidiosis. Int J Dermatol 1996;35:441-3.
[Google Scholar]
2.
Ghorpade A. Polymorphic cutaneous rhinosporidiosis. Eur J Dermatol 2006;16:190-192.
[Google Scholar]
3.
Ghorpade A. Giant cutaneous rhinosporidiosis. J Eur Acad Dermatol Venereol 2006;20:88-89.
[Google Scholar]
4.
Darbari BS, Gupta RL, Shukla IM, Arora MM. Rhinosporidiosis in Raipur. A clinicopathological study of 348 cases. Ind J Pathol and Bacteriol 1972;15:103-107.
[Google Scholar]
5.
Fredricks DN, Jolley JA, Lepp PW, Kosek JC, Relman DA. Rhinosporidium seeberi: A human pathogen from a novel group of aquatic protistan parasites. Emerg Infect Dis 2000;6:273-282.
[Google Scholar]
6.
Shreshtha SP, Hennig A, Parija SC. Prevalence of rhinosporidiosis of the eye and its adenexa in Nepal. Am J Trop Med Hyg 1998;59:231-234.
[Google Scholar]
7.
Nerurkar NK, Bradoo RA, Joshi AA, Shah J, Tandon S. Lacrimal sac rhinosporidiosis: a case report. Am J Otolaryn 2004;25:423-5.
[Google Scholar]

Fulltext Views
294

PDF downloads
49
Show Sections