ARTICLES
Year : 1974 | Volume
: 22 | Issue : 3 | Page : 29--30
Rhinosporidiosis of lacrimal sac
MR Jain1, R Sahai2,
1 Reader in Ophthalmology, Ravinder Nath Tagore Medical College, Udaipur, India
2 General hospital, Jhunjhunu (Rajastan), India
Correspondence Address:
M R Jain
Reader in Ophthalmology, Ravinder Nath Tagore Medical College, Udaipur
India
How to cite this article:
Jain M R, Sahai R. Rhinosporidiosis of lacrimal sac.Indian J Ophthalmol 1974;22:29-30
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How to cite this URL:
Jain M R, Sahai R. Rhinosporidiosis of lacrimal sac. Indian J Ophthalmol [serial online] 1974 [cited 2021 Jan 15 ];22:29-30
Available from: https://www.ijo.in/text.asp?1974/22/3/29/31357 |
Full Text
Rhinosporidiosis is a fungal infection caused by Rhinosporidium Seeberi, first described by Seeber. [2],[8] in It is common in India and Ceylon, [4],[5],[7],[9] but is extremely rare elsewhere. [1],[2] The disease is rare in females. [1],[2] The mode of infection and its transmission is still unknown, but it is thought to be a water born infection. [2],[3] Ocular rhinosporidiosis in India affects conjunctiva (69%), lacrimal sac (24%), canaliculi (4%), lids and sclera (4%).
Case Report
A 5-year male child was admitted to the eye ward with the complaint of gradually increasing painless swelling just underneath the skin, on the right lateral side of the bridge of the nose, for last one year [Figure 1]. Subsequently the swelling started growing rapidly. There was no history of any epistaxis or epiphora.
Parents are agriculturists. No other history was of any significance.
Investigations were non contributory. Syringing of the right sac showed that the passage was partially patent.
Treatment : Medical treatment comprising of antibiotics and steroids led to no improvement. As growth was involving the lacrimal sac, the sac and growth were excised. Bleeding was little more than usual.
Post operative period was uneventful and the patient was discharged on 10th day.
Histopathology: Serial sections through the excised mass confirmed the diagnosis of rhinosporidiosis of the lacrimal sac. Numerous sporocysts in various stages of maturation were seen just underneath the stratified squamous epithelium of the lacrimal sac. Sporocysts are doubly contoured structures with a inner cellulose and outer chitinous layer. The mature sporocysts are termed 'Sporongia'. [Figure 2]a & b.
One of the sporongia ruptured releasing numerous spores in the stroma. Around the spores, stroma showed infiltration with chronic inflammatory cells, consisting of lymphocytes and few plasma cells. [Figure 3].
Discussions
Soft, painless and fluctuating swelling with complete or incomplete blockage of nasolacrimal duct and epistaxis have been described as cardinal clinical features [7] for the diagnosis of rhinosporidiosis of lacrimal sac. The case described had characteristic features except nasal bleeding which probably was absent due to comparatively recent onset of the swelling. Histopathological features of stratified squamous epithelium of lacrimal sac wall having sporocysts in various stages of development confirmed the diagnosis. Recurrences reported as quite frequent, has, however, not been observed in our case till date.
Summary
Lacrimal sac rhinosporidiosis in a male child of 5-years of age belonging to the agricultural community of India has been reported.
References
| 1 | Boyd, William 1967, Text book of Pathology, Lea & Febiger Philadelphia, 328. |
| 2 | Duke Elder, S., 1952, Text book of Ophthalmology, Vol. V, p. 5340, Henry Kimpton, London. |
| 3 | Duke Elder, S. 1965 System of Ophthalmology, Vo. VIII, p. 391, Henry Kimpton, London. |
| 4 | Karunaratne, 1936, J. Path. Bact., 82, 193. |
| 5 | Kirkpatrik 1916, Opthalmoscope, 477. |
| 6 | Kuriakose, E.T., 1963, Brit, J. Ophthal., 47, 346. |
| 7 | Rambo, V.C., 1949, Proc. Indian Ophthal, Soc., 10, 72. |
| 8 | Seeber, (1900), Un neuvo esporozoaria parasite del hombre (Thesis) Buenss Aires. Cited from System of Ophthalmology, Vol. VIII, p. 391. Henry Kimpton, London, 1965. |
| 9 | Wright, (1922), Ind. Med. Gaz., 567, 81. |
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