Ocular Rhinosporidiosis Presenting as Chronic Follicular Conjunctivitis in a Contact Lens Wearer

Rhinosporidiosis is a rare infection caused by Rhinosporidium seeberi, an organism classified in its own class, mesomycetozoea. It commonly affects mucus membranes namely the nasal mucosa, pharynx and the conjunctiva. We present the case of an 8-year-old female who presented with a flat, red, vascular, fleshy, pedunculated mass arising from the tarsal conjunctiva of the right upper eyelid. The mass was completely excised. On histopathological examination, multiple sporangia were seen in various stages of degeneration, consistent with rhinosporidiosis. The diagnosis of rhinosporidiosis is based solely on its microscopic features, and the treatment is surgical excision. This condition is endemic in the temperate regions of the Indian subcontinent, but it has been known to occur even in the colder regions of North America and Eastern Europe. Although a rare clinical entity, the possibility of rhinosporidiosis must be borne in mind when evaluating any polypoidal conjunctival mass.

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“…Suh et al reported a case where rhinosporidiosis presented as chronic follicular conjunctivitis in a 15 years old contact lens wearer. [ 8 ]…”

Section: Discussionmentioning

confidence: 99%

Rhinosporidiosis of the tarsal conjunctiva

Nair

Ali

Kaliki

et al. 2015

Indian J Ophthalmol

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“…The infected lesions usually have a productive character with a grayish deposit on the conjunctiva with further formation of eyelid-eyeball adhesions (in the case of a Candida infection) or papular changes of a white-yellow color (Sporotrichum spp.). In the case of an infection caused by Rhinosporidium, pink or red inflammatory changes have been observed, which may be pedicled and are usually located primarily in the palpebral conjunctiva [10]. Fungal conjunctivitis causes serious complications and requires intensive antifungal therapy; in the case of a Rhinosporidium infection, surgical debridement is also necessary.…”

Section: Conjunctivamentioning

confidence: 99%

Mycotic Infections of the Eye

Słowik¹,

Biernat²,

Urbaniak-Kujda³

et al. 2015

Adv Clin Exp Med

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Fungal infections of the eye are an important cause of significant visual loss and blindness in some regions of the world, especially developing countries. Ocular mycoses remain a diagnostic and therapeutic challenge to the ophthalmologist. Corneal infection is the most frequent presentation, but the orbit, eyelids, lacrimal apparatus, conjunctiva, sclera and internal structures of the eye can also be affected. Candida spp., Fusarium spp. and Aspergillus spp. are the most frequently isolated organisms in fungal keratitis and in endophthalmitis. The difficulties posed by ocular mycoses are mainly related to establishing the clinical diagnosis, isolation of the fungal pathogen and effective local treatment, particularly in infections of the cornea. The critical issue in diagnosing fungal infection of the eye is microbiological identification of the etiologic agent in clinical samples. Early diagnosis and prompt treatment allow serious complications, including blindness, to be avoided. Local, systemic and even surgical treatment is applied in the therapy.

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“…Ocular rhinosporidium most often presents as a polypoid mass of the palpebral conjunctiva [ 17 ]. It may also present as a lacrimal sac diverticulum [ 18 ], recurrent chalazion [ 19 ], conjunctival cyst [ 20 ], chronic follicular conjunctivitis in contact lens wearers [ 21 ], peripheral keratitis [ 22 ], scleral melting [ 23 ], ciliary staphyloma [ 24 ] or simulate a tumour of the eyelid [ 25 ] or periorbital skin [ 26 ]. Large conjunctival lesions may cause mechanical ectropion [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Ocular rhinosporidiosis mimicking conjunctival squamous papilloma in Kenya – a case report

Gichuhi

Onyuma

Macharia³

et al. 2014

BMC Ophthalmol

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BackgroundOcular rhinosporidiosis is a chronic granulomatous infection caused by a newly classified organism that is neither a fungus nor bacterium. It often presents as a benign conjunctival tumour but may mimic other ocular conditions. It is most often described in India. In Africa cases have been reported from South Africa, Kenya, Tanzania, Malawi, Uganda, Congo and Ivory Coast.Case presentationA 54 year old man was seen in Kenya with a lesion that resembled a conjunctival papilloma. We report resemblance to conjunctival papilloma and the result of vital staining with 0.05% Toluidine Blue.ConclusionOcular rhinosporidiosis occurs in East Africa. It may resemble conjunctival squamous papilloma. Vital staining with 0.05% Toluidine blue dye did not distinguish the two lesions well.

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Ocular Rhinosporidiosis Presenting as Chronic Follicular Conjunctivitis in a Contact Lens Wearer

Cited by 11 publications

References 6 publications

Rhinosporidiosis of the tarsal conjunctiva

Rhinosporidiosis of the tarsal conjunctiva

Mycotic Infections of the Eye

Ocular rhinosporidiosis mimicking conjunctival squamous papilloma in Kenya – a case report

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