Rhinofacial conidiobolomycosis caused byConidiobolus coronatusin a Chinese rice farmer

Abstract

We provide the first report of rhinofacial conidiobolomycosis caused by Conidiobolus coronatus in China. The patient was a 36-year-old male rice farmer from Jiang Xi province who presented with diffuse swelling with classical centrofacial distribution and involvement of the right paranasal sinuses. Histopathology showed granulomas with hyphae surrounded by an eosinophilic sheath (Splendore-Hoeppli phenomenon). Culture of biopsy specimens on Sabouraud's dextrose agar led to the growth of fungi with microscopically visible conidiophores and terminal spherical conidia (primary conidium), with multiple secondary conidia and villose conidia. The patient was successfully treated with combination therapy, primarily itraconazole and terbinafine. We conclude with a brief literature review of the epidemiology of conidiobolomycosis.

Human Fungal Pathogens of Mucorales and Entomophthorales

“…Unlike the genus Basidiobolus, numerous species (around 33 species [Nie et al 2012]) have been described; some have been recovered from dead insects and mites and others are parasites of mammals, including C. coronatus (Walker et al 1992;Fischer et al 2008;Yang et al 2010), C. incongruus (Walsh et al 1994;Temple et al 2001), and C. lampragues (Vilela et al 2010;Kimura et al 2011). Because of their distinctive phenotypic features, most agree on the proper identification among the mammalian-pathogenic species that cause conidiobolomycosis.…”

“…Interestingly, small masses, termed "kunkers" by some, are recovered only from the tissues of infected horses (Mendoza and Alfaro 1985); these soft masses have not been described in humans. Most diagnosed human cases of C. coronatus infection are in African adults; however, cases have also been reported in Asia and Latin America (Bittencourt et al 1979;Yang et al 2010;IsaIsa et al 2012). Cases of conidiobolomycosis in the United States and Australia have been diagnosed mainly in horses and dogs (Miller and Campbell 1982).…”

“…The swelling can spread to the cheek, eyes, upper lip, pharynx, and sinus. Thus, nasal obstruction, rhinorrhea, epistaxis, and weight loss are common features of the disease (McGinnis 1980;Yang et al 2010;Isa-Isa et al 2012). In severe chronic cases, bacterial sinusitis is an unwelcome complication of the infection.…”

Mucormycosis and Entomophthoramycosis (Zygomycosis)

“…Infection with this organism tends to involve the trunk and limbs. In contrast, conidiobolomycosis (also known as rhinophycomycosis, rhinoentomophthoromycosis, or nasofacial zygomycosis) is caused by Conidiobolus coronatus or Conidiobolus incongruous, and primarily involves the nose and soft tissues of the face [152,153].…”

First report of Conidiobolus coronatus in Turkey

“…Species of Conidiobolus, most notably the ubiquitous C. coronatus, are recorded as widespread soil saprophytes utilising a variety of substrates, including plant detritus, living plants, different dead arthropods and the fruiting bodies of other fungi in various regions of the world (MacLeod & Müller-Kögler 1973, Keller 1987, Sajap et al 1997, Dromph et al 2001, Laxman et al 2005, Manning et al 2007, Comerio et al 2008. Conidiobolus coronatus, mainly tropical strains, is known to cause disease in both insects and humans (Ribes et al 2000, Prabhu & Patel 2004; the disease has been named rhinophycomycosis, rhinophycomycosis entomophthorae, rhinoentomophthoromycosis, and conidiobolomycosis (King 1979, Ochoa et al 1996, Yang et al 2010.…”