Rhinosporidiosis: A report of 104 cases from Raipur, Chhattisgarh (India).

Background: Rhinosporidiosis is a polypoidal disease of mucocutaneous tissues mainly affecting the nose. Rhinosporidium seeberi is believed to be the causative pathogen; however, the exact identity remains obscure. The main symptoms of the disease include the presence of mass, discharge, epistaxis, and nasal obstruction. The disease is characterized by friable polyps mostly pink to purple giving typical strawberry- or raspberry-like appearance. The infection is caused by bathing in ponds having stagnant waters. Disease is more common in people of lower socioeconomic status. There is no effective medical therapy. Surgical excision with base cauterization is the current treatment modality but recurrences are common. Personal hygiene measures may be effective in reducing the incidence of disease.

Aims and objectives: Analysis of epidemiological factors and clinical presentation of rhinosporidiosis cases from an endemic region and elaboration of essential features of the causative agent of rhinosporidiosis.

Results: In this series, male, rural, and lower-income populations were preponderant. Maximum (45.2%) patients belonged to the age group 18-32 years with a mean age of 23.9 years. Out of 104 operated cases, rhino mass was on the right side in 59, on the left in 39, and bilateral in 6 patients. 74 patients presented with nasal discharge. Epistaxis was present in 63 and shortness of breath in 3 patients. Extension of disease was noticed in 11 patients (10.58%). The passage was blocked in 102 patients. Four patients had dysphagia and nine patients presented with a change in voice. Many patients repeatedly came from a particular area of the old Raipur division (14%-18%). The color of the polyps was light pink or red, raspberry- or strawberry-like. Polyp appeared to be soft and friable with pin head dot-like round bodies (RBs) or sporangia. Mature RBs were seen discharging spores, each one of which is believed to develop into an RB and this cycle continues leading to an increase in the size of the polyp.

Materials and methods: This is an observational cross-sectional study comprising of 104 rhinsosporidiosis patients at a tertiary care hospital over a period of three years between March 2022 and January 2024. Disease was clinically diagnosed and histopathologically confirmed. Patients were examined endoscopically. Spread of mass was confirmed by CT scan. The mass was excised with base cauterization and aseptically collected rhinsosporidiosis biopsies were analysed morpho-histopathologically and microscopically. Epidemiology, demographic factors, and aetiology of disease were analysed. Descriptive statistics were used to summarise the important epidemiological characteristics.

Conclusions: Patients from rural areas and those having lower socioeconomic status having exposure to pond bathing were more affected (73%). As there is no effective medical therapy and recurrences are common, personal hygiene may be the most useful measure to prevent the spread of disease. More intensive research studies need to be conducted to know the exact cause of the disease so that effective therapy can be developed for rhinosporidiosis.