Rare case of disseminated rhinosporidiosis with chronic osteomyelitis of the calcaneum treated by a simple technique of negative pressure wound therapy

Abstract

Occurrence of nasal, cutaneous and disseminated rhinosporidiosis in the same patient is uncommon and involvement of calcaneum is rare. Rhinosporidial osteomyelitis is treated surgically, but multiple recurrences and local spread are common. Many a times, surgical ablation or amputation of the involved area of the limb is carried out to prevent recurrences. We present a case of rhinosporidial osteomyelitis of the calcaneum with a chronic discharging sinus and large lytic lesion in the calcaneum treated by an alternative surgical option in the form of debridement and negative pressure wound therapy.

Rhinosporidiosis—Factors predicting disease recurrence

“…Rarest is the disseminated form when organs like lung, liver, spleen, bones, viscera, genitalia, trunk or limbs are involved. 5 Two patients in the study group had disseminated disease. One among them was seropositive of HIV infection, and the other had received multiple traditional medical treatments.…”

“…Laryngotracheal involvement could be due to direct spillage of spores from the upper airway into the larynx during episodes of bleeding or surgical manipulation. Rarest is the disseminated form when organs like lung, liver, spleen, bones, viscera, genitalia, trunk or limbs are involved 5 . Two patients in the study group had disseminated disease.…”

“…The transmission of infection is by direct contact with the organism or its spores through air, water or fomites. 5 The spores of the organism found in animal faeces and urine can contaminate water and soil. 6 The common risk factors are related to the tropical climate zones, activities involving contact with contaminated soil, mud or water as in cattle farming, river workers and agriculture and habit of bathing in still water like ponds.…”

“…The transmission of infection is by direct contact with the organism or its spores through air, water or fomites 5 . The spores of the organism found in animal faeces and urine can contaminate water and soil 6 .…”

Cryptococcus neoformans osteomyelitis of the calcaneus: Case report and literature review

“…NPWT is a widely used technology in acute, 30 chronic and postoperative wounds, 31 , 32 and chronic osteomyelitis. 33 – 35 It provides moist wound conditions, reduces exudate, control wound-bed infection, and stimulates granulation. 36 Secondary wound closure was done after removal of NPWT.…”