A Rare Case Of Conjunctival Rhinosporidiosis Mimicking A Neoplasm In Ghana.

Abstract

Introduction: Rhinosporidiosis has not been reported in the literature, in Ghana. It is however endemic in India, mostly presenting as tumorous growths within the nasal cavity and conjunctiva. Rhinosporidiosis is a chronic granulomatous infection caused by Rhinosporidium seeberi an organism initially thought to be a fungus, but now newly classified as belonging to a group of fish parasite DRIP clade (Mesomycetozoa) located in the middle (-meso) of the animal(-zoea) and fungal(-myceto) divergence. It has been proposed to be acquired by direct inoculation of traumatized mucosal membranes through contact with contaminated water bodies with aquatic animals as natural hosts. It usually presents as a red granular polypoid mass which may mimick a neoplasm.

Case Presentation: An 8-year-old boy was seen at the Eye clinic with a four-week history of a painless right palpebral conjunctival growth which progressively increased in size over the period. It was excised because it was suspicious for a neoplasm (Papilloma). Histopathological examination confirmed conjunctival Rhinosporidiosis. We report the clinical and histopathological findings of this entity and review the existing literature.

Conclusion: Conjunctival Rhinosporidiosis although rare occurs in our setting. Rhinosporidium seeberi is found in river bodies within our communities and Health care givers should be aware of this infection, which may mimick a neoplastic lesion. It should be included in their differential diagnoses of individuals who present with polypoid conjunctival and nasal masses, who hail from areas with stagnant freshwater bodies in which they routinely bathe or swim.