Rhinosporidiosis-Retrospective Analysis of Cases Presenting in a Tertiary Medical College Hospital in Ernakulam

Abstract

BACKGROUND Rhinosporidiosis is a chronic granulomatous disease caused by the eukaryotic organism, Rhinosporidium seeberi affecting humans and animals. This disease is endemic in several parts of South Asia. The principal purpose of this study was to assess the clinical features of rhinosporidiosis and the demographic profile of the disease in the Ernakulam district. The role of predisposing factors like bathing in ponds, nose-picking habits and the postoperative recurrence rate in the patients were also studied. METHODS This retrospective record-based study was conducted in a tertiary care centre in Ernakulam district of Kerala, India, from January 2014 to June 2016. Clinicopathological profile, demographic data of the patients including their area of residence were retrieved from the records. All patients underwent routine haematological investigation and nasal endoscopy. All rhinosporidial masses were excised and their base cauterised under general anaesthesia, with the aid of endoscope. All patients were given dapsone for 6 months. All cases were followed up for a one-year postoperative period. The retrospective data obtained were entered in Microsoft Excel spreadsheet and analysed. RESULTS The patients in the series were between 14 to 60 years of age. There were 12 male and 3 female patients. Most patients came from the urban areas of the Ernakulam district. The main symptoms were nasal obstruction, epistaxis and nasal mass. The nose and nasopharynx were the commonest sites involved. The inferior meatus and floor of the nasal cavity were the common sites of attachment. Most of the nasal masses were pedunculated and multiple. Recurrent cases, which had previously been operated elsewhere formed the majority in the case series. None of the operated cases in the series showed recurrence during one year follow up. Most cases were associated with the O+ blood group. Nasal synechia was the most common sequelae of repeated surgeries. CONCLUSIONS This study revealed the endemic nature of this disease in Ernakulam and surrounding districts. The results showed the disease was associated more with the male gender, the young, bathing in stagnant water and the O+ blood group. Most of the cases came from an urban background. The study showed the complications of recurrent surgeries and the need for careful removal of the rhinosporidial masses under general anaesthesia. It also emphasises the need for educating the general public against bathing in contaminated water bodies. KEY WORDS Rhinosporidiosis, Rhinosporidium, Epidemiology, Recurrence, Retrospective Studies