ABSTRACT
Background: Rhinosporidiosis is a chronic inflammatory granulomatous disease caused by the organism Rhinosporidiumseeberi. This causal organism was once believed to be a sporozoan, but is now considered to be a fungus. The disease ispresent all over the world except in Australia. However, it is endemic only in India and Sri Lanka; more than 95% of reportedcases are from these two countries. The most common site of manifestation of rhinosporidiosis in man is the nose accountingfor about 70% of cases. Surgical excision remains the mainstay of treatment today even though dapsone and ketoconazolehave been tried to some extent in preventing recurrence after surgery.Aim of the Study: The aim of the study was to study the prevalence, distribution, clinical behavior, results of various forms oftreatment and to provide a baseline clinical data and to supplement information for ongoing studies in the field of rhinosporidiosis.Materials and Methods: A total of 20 patients diagnosed as rhinosporidiosis, who attended the ENT Outpatient Department ofMedical College Hospital, Calicut, during the period from December 1998 to November 1999. Detailed history was recorded andpatients were subjected to thorough otolaryngological examination. Special attention was given to the site of lesions and type ofattachment. Details were also collected with particular reference to bathing habits, occupation, contact with animals, and occurrenceof similar illness in the family or in the neighborhood. Investigations included regular blood and urine and blood grouping. All thepatients underwent surgical excision of the lesions. The diagnosis was confirmed by histopathological examination of specimenobtained postoperatively. 100 mg of dapsone was administered daily (50 mg daily in children), 6 days a week, for a period of 6 months.All patients were reviewed for follow-up at the end of 1 month, 2, 4, and 6 and 9 months and on completion of a year after surgery.Observations and Results: In this study, the average age of patients suffering from rhinosporidiosis was 30.6 ± 2.80 years and theage varied between 8 and 52 years. The sex incidence was as follows: Males 17 (85%), females 3 (15%). Male predominance wasseen in this series and the male to female ratio was 5.66:1. Most of the subjects suffering from rhinosporidiosis were manual laborers7 (35%) out of 20, of which 2 (10%) were agricultural workers. The other major group was students accounting for 5 (25%) out of20 cases. The external appearance of the nose was normal in all patients. Partial nasal obstruction was seen in 13 cases (65%),on the left six, on the right five, and bilateral two cases. The total obstruction was seen in 5 cases (25%) – left two, right two, andbilateral one. Both nasal cavities were patent in only two cases. The vestibule showed the presence of mass in four cases (20%).Conclusions: Rhinosporidiosis is not an uncommon disease encountered in day-to-day ENT practice. The occurrence of thedisease does not bear any relation to the occupation of the patient. The maximum incidence of rhinosporidiosis is seen inthe age group of 21–30 years and males predominate. Rhinosporidiosis is more common in the rural population. There is asignificant association between dip baths in ponds and the occurrence of disease.