Rhinosporidiosis: A formidable beast lurking within the nostril: A case report

Rhinosporidiosis is a chronic granulomatous condition caused by Rhinosporidium seeberi, a waterborne pathogen that has been known for more than a century. It predominantly affects the mucous membranes of the nasal cavity, conjunctiva, and occasionally other anatomical sites, including the oropharynx, larynx, trachea, and genitalia. The disease manifests as slow-growing, polypoid, friable masses that are highly vascularized and prone to recurrent bleeding. These lesions can lead to symptoms such as nasal obstruction, epistaxis and discomfort, significantly impacting a patient’s quality of life. Rhinosporidiosis generally presents as mass attached to anterior part of the nasal septum, sometimes extends into the nasopharynx but what makes our case interesting is the fact that an isolated mass was seen extending into the nasal vestibule, which is a rare presentation. A 13-year-old male was brought to otorhinolaryngology OPD by his parents with complaints of left sided nasal obstruction since a month. The patient reported experiencing a sensation akin to a mass within the left nasal cavity. The patient had a history of frequent bathing and swimming activities in natural lakes in his village. Upon examination by anterior rhinoscopy, a non-tender, mobile, pink polypoid mass was identified in the left nasal cavity, characterized by its propensity to bleed upon palpation. Due to its widespread occurrence in rural areas characterized by significant exposure to polluted water sources, enhancing public awareness and advocating for preventive strategies, such as the avoidance of stagnant water and the advancement of water sanitation, can significantly alleviate the burden of rhinosporidiosis in endemic territories. The complete endoscopic removal of the mass without traumatising adjacent structures followed by cauterisation of the base and administration of Dapsone therapy is recommended as a preventive measure against recurrences.