60-year-old male complaints of right-sided nasal obstruction and nasal discharge, which sometimes is blood tinged. Biopsy finding is also shown below. What is your diagnosis?
High-Yield Explanation
RhinosporidiosisIt is a chronic granulomatous disease caused by Rhinosporidium seeberi and affects both man and animals.The disease mostly affects nose and nasopharynxThe disease is acquired through the contaminated water of ponds also frequented by animals. In the nose, the disease presents as a leafy, polypoidal mass, pink to purple in color and attached to the nasal septum or lateral wall. The mass is very vascular and bleeds easily on touch. Its surface is studded with white dots representing the sporangia of fungus. In early stages, the patient may complain of nasal discharge which is often blood tinged and nasal stuffiness. Sometimes, frank epistaxis is the only presenting complaint.Diagnosis: This is made by biopsy. It shows several sporangia, oval or round in shape and filled with spores which may be seen bursting through its chitinous wall. It has not been possible to culture the organism or transfers the disease to experimental animals.Treatment:Complete excision of the mass with diathermy knife and cauterization of its base. Recurrence may occur after surgical excision. Not many drugs are effective against the disease. Dapsone has been tried with some success.Ref: Dhingra; 6th ed; Pg: 159