Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Rhinosporidiosis- Epidemiological, Clinicoradiological, Immunological Profile

Document Type : Original

Authors
Megha Chandran 1
Rupa Mehta 1
Nitin Madhusudan Nagarkar 1
Anudita Bhargava 2
Eli Mohapatra 3
Saroj Pati 4
1 Department of ENT-Head and Nech Surgery, AIIMS Raipur, India.
2 Department of Microbiology, AIIMS Raipur, India.
3 Department of Biochemistry, AIIMS Raipur, India.
4 Department of Radiology, AIIMS Raipur, India.
10.22038/ijorl.2023.68378.3331
Abstract
Introduction:

Rhinosporidiosis is an enigmatic disease with many unsolved queries right from taxonomy to treatment. This study has been done to understand the disease characteristics with a peek into the lesser known immunological aspects of it by studying the changes in levels of certain primarily cell-mediated immunity (CMI)-specific cytokines in rhinosporidiosis patients.

Materials and Methods:

A prospective observational study was performed. Detailed epidemiological and clinicoradiological assessment was done along with selected inflammatory and immunological markers. The tests for immunological parameters were done by ELISA and CLIA and data were compiled and analyzed using appropriate statistics.

Results:

Disease showed male predominance and all patients gave a universal pond bathing history. Majority patients had O+ve blood group. Right side was affected most with nasal obstruction being commonest symptom. Nasal cavity was involved in majority of cases with inferior turbinate and meatus being sites of maximum occurrence and attachment. Nasopharynx, oropharynx were other involved sites. Extra-nasal sites included skin and parotid gland. Endoscopic and CECT findings were similar and confirmed intraoperatively. Tests for inflammatory markers showed no significant change in patients. Immunological markers -IL-6, TNF-beta- levels showed significant increase though no such increase was found with IFN-gamma levels.

Conclusion:

Rhinosporidiosis has a definite epidemiological and clinical-radiological profile. A clear association with exposure to contaminated water is present which could not be further associated with disease duration or recurrence. The immunological profile needs to be further investigated upon since it remains quite elusive.
Keywords
Endemic
Cell-mediated immunity
Cytokines
IL-6
TNF-beta
IFN-gamma
Subjects
  1. Herr RA, Ajello L, Taylor JW, Arseculeratne SN, Mendoza L. Phylogenetic Analysis of Rhinosporidium seeberi’s 18S Small-Subunit Ribosomal DNA Groups This Pathogen among Members of the Protoctistan Mesomycetozoa Clade. Journal of Clinical Microbiology. 1999 Sep; 37(9): 2750–4.
  2. Ajello L. Ecology and epidemiology of hydrophilic infectious fungi and parafungi of medical mycological importance: a new category of pathogens. Topley & Wilson’s microbiology and microbial infections,. 1998;4:67–73.
  3. França GV, Gomes CC, Sakano E, Altemani AM, Shimizu LT. [Nasal rhinosporidiosis in children]. J Pediatr (Rio J). 1994 Oct;70(5):299–301.
  4. Mehta, R., Singh, A., Nagarkar, N.M. (2022). Research Topics in Rhinosporidiosis. In: Nagarkar, N.M., Mehta, R. (eds) Rhinosporidiosis . Springer, Singapore; 2022. pp.99-101.
  5. Arseculeratne SN. Recent advances in rhinosporidiosis and Rhinosporidium seeberi. Indian J Med Microbiol. 2002 Sep;20(3):119–31.
  6. Dutta S, Haldar D, Dutta M, Barik S, Das Biswas K, Sinha R. Socio-demographic Correlates of Rhinosporidiosis: A Hospital-Based Epidemiologic Study in Purulia, India. Indian J Otolaryngol Head Neck Surg. 2017 Mar 1;69(1):108–12.7.
  7. Das S, Kashyap B, Barua M, Gupta N, Saha R, Vaid L, et al. Nasal rhinosporidiosis in humans: new interpretations and a review of the literature of this enigmatic disease. Med Mycol. 2011 Apr; 49(3):
    311–5.
  8. Saha J, Basu AJ, Sen I, Sinha R, Bhandari AK, Mondal S. Atypical presentations of rhinosporidiosis: a clinical dilemma? Indian J Otolaryngol Head Neck Surg. 2011 Jul;63(3):243–6.
  9. Karthikeyan P, Vijayasundaram S, Pulimoottil DT. A Retrospective Epidemiological Study of Rhinosporidiosis in a Rural Tertiary Care Centre in Pondicherry. J Clin Diagn Res. 2016 May; 10(5): MC04–8.
  10. Guru RK, Pradhan DK. Rhinosporidiosis with special reference to extra nasal presentation. Journal of Evolution of Medical and Dental Sciences. 2014 Jun 2; 3(22):6189–200.
  11. Williams J, Nagarkar NM, Metha R, Satpute S, Bugalia A. A Rare Presentation of Rhinosporidiosis. Indian Journal of Otolaryngology and Head & Neck Surgery. 2017 Dec;69(4):559.
  12. Sengupta S, Pal S, Biswas BK, Jana S, Biswas S, Minz RS. Clinico-pathological study of 273 cases of rhinosporidiosis over a period of ten years in a tertiary care institute catering predominantly rural population of tribal origin. Bangladesh Journal of Medical Science. 2015;14(2):159–64.
  13. Sudarshan V, Goel NK, Gahine R, Krishnani C. Rhinosporidiosis in Raipur, Chhattisgarh: a report of 462 cases. Indian J Pathol Microbiol. 2007 Oct 1; 50(4):718–21.
  14. Herr RA, Mendoza L, Arseculeratne SN, Ajello L. Immunolocalization of an endogenous antigenic material of Rhinosporidium seeberi expressed only during mature sporangial development. FEMS Immunology & Medical Microbiology. 1999; 23(3): 205–12.
  15. de Silva NR, Huegel H, Atapattu DN, Arseculeratne SN, Kumarasiri R, Gunawardena S, et al. Cell-mediated immune responses (CMIR) in human rhinosporidiosis. Mycopathologia. 2001; 152(2): 59–68.

 

Iranian Journal of Otorhinolaryngology
Volume 35, Issue 5 - Serial Number 130
September and October 2023
Pages 255-262