1
|
Maneksha V, Aparna KS, Kavya S, Debaruna G. Lacrimal Sac Rhinosporidiosis: Clinical Profile and Gram Stain as a Method of Preoperative Diagnosis. Ophthalmic Plast Reconstr Surg 2023; 39:454-457. [PMID: 36972121 DOI: 10.1097/iop.0000000000002348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
PURPOSE To describe the clinical profile of lacrimal sac rhinosporidiosis and to introduce a method for preoperative microbial identification of rhinosporidiosis using Gram stain. METHODS This is a prospective study, carried out from January 2016 to January 2022. This series included 18 patients with clinical suspicion of lacrimal sac rhinosporidiosis. All patients underwent a comprehensive eye check-up. Mucopurulent discharge collected by a sterile swab after applying pressure over the sac area and Gram staining was done. All patients underwent dacryocystectomy. The sac contents were sent for histopathology, and rhinosporidiosis was confirmed. RESULTS A total of 18 patients over a period of 6 years with suspicion of lacrimal sac rhinosporidiosis were included. There were 11 (61.1%) male patients. Ten patients (55.5 %) had a history of either regular or occasional bathing in stagnant water. Nontender doughy swelling over the lacrimal sac region was the most common presentation. Gram staining of the mucopurulent discharge revealed thick-walled sporangia with endospores suggestive of rhinosporidiosis in all these cases. All patients underwent dacryocystectomy. Hematoxylin and eosin sections confirmed the diagnosis. Two patients had recurrence within 6 months after surgery. CONCLUSION Regurgitation of pus mixed with whitish granular particles or blood is highly suspicious of rhinosporidiosis. In clinically suspected cases, microbial diagnosis using Gram stain is an economical, office procedure, which helps the surgeon to plan for the surgery and for better counseling.
Collapse
Affiliation(s)
- Velu Maneksha
- Department of Orbit and Oculoplasty, Aravind Eye Hospital, Tirunelveli, Tamilnadu, India
| | | | | | | |
Collapse
|
2
|
Gonugunta V, Dipankar D, Sujatha TS, Kuppuraj D, Pabolu C, Radhakrishnan S. A rare case report of oculosporidiosis from South India: 'Fish Egg' appearance means a lot. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2022. [DOI: 10.4103/tjosr.tjosr_160_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
3
|
Pradhan P, Samal S. Rhinosporidiosis of the lacrimal sac masquerading as chronic dacryocystitis: a rare presentation. AUTOPSY AND CASE REPORTS 2021; 11:e2020214. [PMID: 33968816 PMCID: PMC8020589 DOI: 10.4322/acr.2020.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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.
Collapse
Affiliation(s)
- Pradeep Pradhan
- All India Institute of Medical Sciences, Department of ENT and Head Neck Surgery, Bhubaneswar, Odisha, India
| | - Swagatika Samal
- All India Institute of Medical Sciences, Department of Pathology, Bhubaneswar, Odisha, India
| |
Collapse
|
4
|
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 J Ophthalmol 2019; 33:283-290. [PMID: 31686971 PMCID: PMC6819728 DOI: 10.1016/j.sjopt.2019.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 11/26/2022] Open
Abstract
Rhinosporidiosis is a chronic granulomatous disease affecting the mucous membrane primarily and is caused by Rhinosporidium seeberi, an aquatic protistan parasite. The nose is the most common site of involvement and is seen in 83.3% cases, followed by ocular involvement in 11.2% cases and other sites like larynx, trachea and bronchus in 5.5% cases. In various oculosporidiosis case series, lacrimal drainage system involvement was seen to vary from 14.3% to 59.6% cases. Isolated lacrimal sac involvement in rhinosporidiosis was found in 45.8% (72 out of 157) cases of the lacrimal drainage system in a review of 31 studies. A variety of surgical procedures have been used to treat rhinosporidiosis of lacrimal sac like dacryocystorhinostomy, Dacryocystectomy, lateral rhinotomy and local lesion excision with a success rate varying from 28.5% to 92.3%. This wide variation in the success rate was due to the fact that a uniform surgical procedure was performed in all the cases of a particular series irrespective of the extent of disease. Grading the lacrimal sac rhinosporidiosis to decide the extent of surgical excision may help achieve better results. We present a grading system based on our own experience in a case of extensive rhinospodiosis of lacrimal sac and review of 31 studies published in the literature. A 24-year-old male from Nepal presented with the complaints of watering from his right eye of 13 years duration, swelling in the right medial canthal area with an extension to the inferior part of the orbit for 12 years and nasal blockage for 1.5 years. The patient had a history of previous intervention in which biopsy was taken from the nose and sent for histopathology that confirmed rhinosporidiosis. An extended intranasal endoscopic dacryocystectomy was done along with debridement and coblation of the lesion over the septum and nasopharynx. Intraoperatively a large rhinosporidiosis mass was seen filling the sac and was removed in toto along with the sac and nasolacrimal duct. Recurrence of a tiny lesion after 6 months in our case despite wide excision with the drilling of bony nasolacrimal duct and coblation, made us review the literature.
Collapse
Affiliation(s)
- Nishi Gupta
- Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi 110002, India
| | - Poonam Singla
- Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi 110002, India
| | | | | |
Collapse
|
5
|
Bothra N, Rath S, Mittal R, Tripathy D. External dacryocystorhinostomy for isolated lacrimal sac rhinosporidiosis - A suitable alternative to dacryocystectomy. Indian J Ophthalmol 2019; 67:665-668. [PMID: 31007236 PMCID: PMC6498928 DOI: 10.4103/ijo.ijo_1136_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose: To describe the outcome of external dacryocystorhinostomy (DCR) as a suitable alternative to dacryocystectomy (DCT) in cases of isolated lacrimal sac rhinosporidiosis. Methods: This was a retrospective, interventional case series. Institutional review board approval was obtained for the study. The chart review of 13 patients who underwent external DCR surgery for isolated lacrimal sac rhinosporidiosis between July 2012 and May 2018 was performed. Demographic details, clinical presentation, preoperative and intraoperative findings, surgical technique used, postoperative management, surgical outcome and duration of follow up were reviewed for each patient. Results: Thirteen patients were included in the study. Nine (69.2%) were male and four (30.8%) were female. The mean age was 22.1 years (range: 8–46 years). Involvement was unilateral in all cases. The commonest presenting complaint was epiphora with discharge seen in 10 cases (76.9%). An intrasac granuloma was grossly identified intraoperatively in 12 out of the 13 patients. Mean follow up was 26.9 months (range: 1.5–68 months). Till the last follow up, all cases were symptom free and did not have any evidence of recurrence of infection. Conclusion: From this series of cases reported by the authors, external DCR with appropriate precautions to prevent recurrence appears to be a suitable alternative to conventional DCT with excellent long-term outcomes without disease recurrence.
Collapse
Affiliation(s)
- Nandini Bothra
- Ophthalmic Plastics, Orbit and Ocular Oncology Services, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Suryasnata Rath
- Ophthalmic Plastics, Orbit and Ocular Oncology Services, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Ruchi Mittal
- Kanupriya Dalmia Ophthalmic Pathology Laboratory, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Devjyoti Tripathy
- Ophthalmic Plastics, Orbit and Ocular Oncology Services, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| |
Collapse
|
6
|
Rajesh Raju G, Sandeep S. Lacrimal Sac Rhinosporidiosis and Surgical Management by Transnasal Endoscopic Excision: A Case Series. Laryngoscope 2018; 128:2693-2696. [PMID: 30194840 DOI: 10.1002/lary.27322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To study the clinical profile and the route of spread of lacrimal sac rhinosporidiosis. To device a standard transnasal endoscopic surgical procedure in the treatment of lacrimal sac rhinosporidiosis. METHODS This is a retrospective analysis of a case series on lacrimal sac rhinosporidiosis. Thirteen cases of lacrimal sac rhinosporidiosis reported in our institution from July 2003 to July 2016 were included. Workup included diagnostic nasal endoscopy and lacrimal syringing. All patients underwent transnasal endoscopic excision of rhinosporidiosis. RESULTS Lacrimal sac rhinosporidiosis was more prevalent among males and in the 31 to 40 years age group. All patients had a history of bathing in stagnant water bodies. The most common clinical presentation was a doughy swelling medial to the medial canthus. Lacrimal sac rhinosporidiosis invariably presented with involvement of the nasolacrimal duct. Following the endoscopic excision of lacrimal sac rhinosporidiosis, all patients were followed up for a mean period of 16 months, and only one patient had recurrence. CONCLUSION A unique aspect of our case series is that patients presented with features pertaining to isolated lacrimal system involvement rather than sinonasal involvement. Involvement of the nasolacrimal duct and nasal cavity without involvement of the eyes in all cases confirms the retrograde spread of rhinosporidiosis from the nasal cavity into the lacrimal sac via the nasolacrimal duct as the most common route of spread of infection. We recommend that endoscopic dacryocystorhinostomy, along with nasolacrimal duct excision used for surgical management in our case series with superior results, must become the standard of care in treatment of this condition. LEVEL OF EVIDENCE 4 Laryngoscope, 128:2693-2696, 2018.
Collapse
Affiliation(s)
- George Rajesh Raju
- Department of Otolaryngology, Little Flower Hospital, Angamaly, Kerala, India
| | - Suresh Sandeep
- Department of Otolaryngology, Little Flower Hospital, Angamaly, Kerala, India
| |
Collapse
|
7
|
Affiliation(s)
- Rajesh Subhash Joshi
- Department of Ophthalmology, Vasantrao Naik Government Medical College, Yavatmal, Maharashtra, India
| |
Collapse
|
8
|
John D, Selvin SST, Irodi A, Jacob P. Disseminated Rhinosporidiosis with Conjunctival Involvement in an Immunocompromised Patient. Middle East Afr J Ophthalmol 2017; 24:51-53. [PMID: 28546693 PMCID: PMC5433129 DOI: 10.4103/meajo.meajo_89_15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rhinosporidiosis is a granulomatous infection of mucocutaneous tissue caused by Rhinosporidium seeberi that most commonly occurs in the nasal cavity. Ocular rhinosporidiosis affects primarily the conjunctiva. Diagnosis of rhinosporidiosis is based on strong clinical suspicion and is confirmed by histopathological examination. We report a rare case of conjunctival rhinosporidiosis in an immunocompromised patient (human immunodeficiency virus) with disseminated cutaneous rhinosporidiosis. A 44-year-old male presented with a swelling in the right upper eyelid for 6 months. Excision biopsy of the ocular lesion showed multiple thick-walled, variable-sized sporangia containing endospores within the subepithelium suggestive of rhinosporidiosis. A multidrug regimen of systemic cycloserine, ketoconazole, and dapsone was administered to treat disseminated rhinosporidiosis, in addition to antiretroviral therapy. There was good response with reduction in the swellings.
Collapse
Affiliation(s)
- Deepa John
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Satheesh S T Selvin
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Aparna Irodi
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pushpa Jacob
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
9
|
Basu SK, Bain J, Maity K, Chattopadhyay D, Baitalik D, Majumdar BK, Gupta V, Kumar A, Dalal BS, Malik A. Rhinosporidiosis of lacrimal sac: An interesting case of orbital swelling. J Nat Sci Biol Med 2016; 7:98-101. [PMID: 27003980 PMCID: PMC4780178 DOI: 10.4103/0976-9668.175102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Rhinosporidiosis is a chronic localized granulomatous disease caused by Rhinosporidium seeberi, an aquatic protistan parasite belonging to a clade, Mesomycetozoea. Infestation of Rhinosporidiosis to the eye and adnexa is termed oculosporidiosis, in such cases, conjunctival mucosa is mostly involved; however in our case, it involved only the lacrimal sac and deeper periorbital tissue and presented as a case of orbital swelling. Surgical excision of the lesion was done, postoperatively dapsone therapy was given for 6 months, and the patient responded very well with no recurrence till date.
Collapse
Affiliation(s)
- Sandip Kanti Basu
- Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Jayanta Bain
- Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Kuntal Maity
- Department of ENT, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Debarati Chattopadhyay
- Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Debasis Baitalik
- Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Bijay Kumar Majumdar
- Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Vivek Gupta
- Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Ashwini Kumar
- Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Bibhas Saha Dalal
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Anu Malik
- Department of Ophthalmology, NDMC Medical College and Hindu Rao Hospital, New Delhi, India
| |
Collapse
|
10
|
Nuruddin M, Mudhar HS, Osmani M, Roy SR. Lacrimal sac rhinosporidiosis: clinical profile and surgical management by modified dacryocystorhinostomy. Orbit 2014; 33:29-32. [PMID: 24195743 DOI: 10.3109/01676830.2013.844170] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To describe the clinical profile and surgical management of patients with lacrimal sac rhinosporidiosis. METHODS This is a retrospective interventional case series. Eighteen patients, who were clinically diagnosed as isolated lacrimal sac rhinosporidiosis between October 2009 to January 2012, were included in the study. Detailed history, including whether there was exposure to stagnant bathing water, was noted. All patients underwent modified dacryocystorhinostomy (DCR) under general anaesthesia. RESULT Out of 18 patients, 14 were male and 4 were female. Rhinosporidiosis was more prevalent in the 25 to 34 years age group. The most common clinical presentation was a doughy swelling over the lacrimal sac area, present in all cases. Twelve patients (66.67%) had a history of bathing in stagnant water. After modified DCR operation, all patients were followed for one year and only two patients had recurrence of their disease. CONCLUSION Patients with lacrimal sac rhinosporidiosis usually present with a soft, doughy swelling in the lacrimal sac area. Bathing in stagnant water is a common risk factor. A modified DCR yields excellent outcomes.
Collapse
Affiliation(s)
- Murtuza Nuruddin
- Consultant, Orbit and Oculoplastic Clinic, Chittagong Eye Infirmary and Training Complex , Chittagong , Bangladesh
| | | | | | | |
Collapse
|
11
|
Ganekal S, Dorairaj S, Hegde S, Jhanji V. Conjunctival rhinosporidiosis. J AAPOS 2013; 17:432-3. [PMID: 23871136 DOI: 10.1016/j.jaapos.2013.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 03/04/2013] [Accepted: 03/13/2013] [Indexed: 10/26/2022]
Abstract
A 12-year-old boy presenting with redness and foreign body sensation in his right eye was found to have a granular, pedunculated mass in the upper palpebral conjunctiva near the lid margin. After the mass was excised, the conjunctiva healed completely, with mild overlying scarring. At 6 weeks' follow-up, there was no evidence of recurrence. Histopathological examination of the mass revealed multiple sporangia characteristic of conjunctival rhinosporidiosis.
Collapse
|
12
|
Rogers S, Waring D, Martin P. Recurrent lacrimal sac rhinosporidiosis involving the periocular subcutaneous tissues, nasolacrimal duct and nasopharynx. Orbit 2013; 31:358-60. [PMID: 23030407 DOI: 10.3109/01676830.2012.700548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Rhinosporidiosis is a chronic infection caused by the organism Rhinosporidium seeberi. It is endemic in parts of southern India and Sri Lanka, but rarely seen outside these areas. The infection predominantly affects the nasal mucosa; however, it can also affect the ocular surface and adnexa. We present a case of rhinosporidiosis initially involving the lacrimal sac, with recurrence in the periocular subcutaneous tissues, nasolacrimal duct and nasopharynx.
Collapse
|
13
|
Reader’s Views Lacrimal Sac Diverticulum due to Rhinosporidiosis. Indian J Otolaryngol Head Neck Surg 2011; 63:411. [DOI: 10.1007/s12070-011-0173-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Accepted: 05/14/2008] [Indexed: 10/17/2022] Open
|
14
|
Saha J, Basu AJ, Sen I, Sinha R, Bhandari AK, Mondal S. Atypical presentations of rhinosporidiosis: a clinical dilemma? Indian J Otolaryngol Head Neck Surg 2011; 63:243-6. [PMID: 22754802 PMCID: PMC3138954 DOI: 10.1007/s12070-011-0275-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Accepted: 05/24/2011] [Indexed: 11/24/2022] Open
Abstract
Rhinosporidiosis is a chronic inflammatory disease common in India and Sri Lanka. Its manifestations are mostly nasal, though extranasal ones in head and neck region are not rare. Occasionally these presentations lead to diagnostic dilemma. Here we present some cases with its associated confusions if any. In this study thirty five patients were included. Extranasal manifestations were noted in nine cases. Two patients attended with laryngopharyngeal and one with lacrimal sac presentation-subsequent nasal endoscopic examination revealed presence of nasal masses, too. Other six cases presented with polypoidal mass hanging from nasopharynx into oropharynx. One of them was confused with nasopharyngeal angiofibroma. Two laryngopharyngeal masses were removed successfully with rigid laryngoscope followed by cauterisation of the base. The solitary lacrimal sac mass was excised by external approach combined with nasal endoscope guided excision of nasal mass. The other six cases with nasopharyngeal attachment were subjected to nasal endoscope guided removal. In all these cases, the base of the lesions was cauterised. The experience about the various manifestations and diagnostic problems is discussed here.
Collapse
Affiliation(s)
- Jayanta Saha
- R.G. Kar Medical College and Hospital, Kolkatta, India
- Flat No. 2D, Block 2, Shrachi Village, Madhyamgram, Kolkata, 700129 West Bengal India
| | | | - Indranil Sen
- R.G. Kar Medical College and Hospital, Kolkatta, India
| | - Ramanuj Sinha
- R.G. Kar Medical College and Hospital, Kolkatta, India
| | | | | |
Collapse
|
15
|
Jacob P, Rose JS, Hoshing A, Chacko G. Tectonic corneal graft for conjunctival rhinosporidiosis with scleral melt. Indian J Ophthalmol 2011; 59:251-3. [PMID: 21586855 PMCID: PMC3120253 DOI: 10.4103/0301-4738.81046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 16 year old girl presented with irritation and watering of the right eye for 3 months. On examination, the superior perilimbal sclera was ectatic with incarcerated uveal tissue covered by conjunctiva. The conjunctiva showed discreet, yellow white mucoid spots. Excision biopsy of the conjunctiva showed subepithelial spherules of sporangia containing numerous endospores, suggestive of rhinosporidiosis. Diathermy was applied to flatten the staphyloma. The ectatic area was covered with a corneal patch graft. The patient was started on prednisolone acetate eye drops and oral dapsone for 6 months. Corneal graft was well incorporated and conjunctivalized by 3 months. Since the graft was not seen within the palpebral aperture, there was good cosmetic result. The corneal graft had the added advantage of transparency which allowed visualization of the underlying tissue to diagnose early recurrence. There was no recurrence at 6 months.
Collapse
Affiliation(s)
- Pushpa Jacob
- Department of Ophthalmology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | | | | | | |
Collapse
|
16
|
Primary Lacrimal Sac Rhinosporidiosis With Grossly Dilated Sac and Nasolacrimal Duct. Ophthalmic Plast Reconstr Surg 2009; 25:234-5. [DOI: 10.1097/iop.0b013e3181a39495] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
17
|
Authors′ reply. Indian J Ophthalmol 2008. [PMCID: PMC2636047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
18
|
Castelino AM, Rao SK, Biswas J, Gopal L, Madhavan HN, Kumar SK. Conjunctival rhinosporidiosis associated with scleral melting and staphyloma formation: diagnosis and management. Cornea 2000; 19:30-3. [PMID: 10632005 DOI: 10.1097/00003226-200001000-00007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Although conjunctival rhinosporidiosis is endemic in India, associated scleral melting and staphyloma formation are quite rare. We report clinical features and management in three patients with this unusual presentation. METHODS Retrospective review of case records of three patients with conjunctival rhinosporidiosis. RESULTS Infection occurred in young, healthy adults and was localized to the forniceal conjunctiva in all patients. The affected conjunctiva had numerous grey-white spherules, but a polyp-like lesion was not present in any patient. Diagnosis was based on clinical features and examination of scrapings from the involved conjunctiva. Treatment was surgical, with excision of infected conjunctival tissues and staphyloma repair with homologous sclera or autogenous periosteum. Failure to recognize the conjunctival pathology in one patient resulted in recurrence of the staphyloma. CONCLUSION Conjunctival rhinosporidiosis can be associated with scleral staphyloma in young, healthy, adults. Differentiating this entity from idiopathic scleral ectasia requires knowledge of the clinical features of conjunctival rhinosporidiosis and a high index of clinical suspicion.
Collapse
Affiliation(s)
- A M Castelino
- Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
| | | | | | | | | | | |
Collapse
|
19
|
De Doncker RM, de Keizer RJ, Oosterhuis JA, Maes A. Scleral melting in a patient with conjunctival rhinosporidiosis. Br J Ophthalmol 1990; 74:635-7. [PMID: 2285690 PMCID: PMC1042237 DOI: 10.1136/bjo.74.10.635] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A remarkable case of a scleral melting reaction in association with conjunctival rhinosporidiosis is presented and its surgical treatment with a scleral graft described.
Collapse
Affiliation(s)
- R M De Doncker
- Department of Ophthalmology, University Hospital, Leiden, The Netherlands
| | | | | | | |
Collapse
|
20
|
Krishnan MM, Kawatra VK, Rao VA, Ratnakar C. Diverticulum of the lacrimal sac associated with rhinosporidiosis. Br J Ophthalmol 1986; 70:867-8. [PMID: 3098278 PMCID: PMC1040845 DOI: 10.1136/bjo.70.11.867] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A rare case of diverticulum of the lacrimal sac associated with rhinosporidiosis is reported. The clinical presentation and possible pathogenesis are discussed.
Collapse
|
21
|
|
22
|
Anibal Rolon P. [Epidemiology of rhinosporidiosis in the Republic of Paraguay]. MYCOPATHOLOGIA ET MYCOLOGIA APPLICATA 1974; 52:155-71. [PMID: 4407372 DOI: 10.1007/bf02198738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
23
|
Firouz-Abadi A, Moghimi M, Azad Y. Rhinosporidiosis in Iran (Persia)--a study of seventy-four cases. MYCOPATHOLOGIA ET MYCOLOGIA APPLICATA 1971; 44:249-60. [PMID: 4935361 DOI: 10.1007/bf02128638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
24
|
Lamba PA, Shukla KN, Ganapathy M. Rhinosporidium granuloma of the conjunctiva with scleral ectasia. Br J Ophthalmol 1970; 54:565-8. [PMID: 5458682 PMCID: PMC1207913 DOI: 10.1136/bjo.54.8.565] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
25
|
|