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Case Reports
. 2018 Nov;18(4):e549-e552.
doi: 10.18295/squmj.2018.18.04.022. Epub 2019 Mar 28.

A Rhinofacial Conidiobolus coronatus Fungal Infection Presenting as an Intranasal Tumour

Levente Deak  1 , Savitha Mudalagiriyappa  2 , Annelyse Ballin  3 , David Saxton  1 , Arunaloke Chakrabarti  4
Affiliations
Case Reports

A Rhinofacial Conidiobolus coronatus Fungal Infection Presenting as an Intranasal Tumour

Levente Deak et al. Sultan Qaboos Univ Med J. 2018 Nov.

Abstract

Conidiobolomycosis is a rare fungal infection that affects adults in tropical regions. We report a 42-year-old male patient who was referred to the Sulaiman Al Habib Hospital, Dubai, United Arab Emirates (UAE), in 2013 with excessive nasal bleeding and a suspected nasal tumour. He reported having briefly visited central India nine months previously. Computed tomography and magnetic resonance imaging showed a highly vascularised mass in the nasal cavity. However, after surgical excision, initial treatment with amphotericin B deoxycholate was unsuccessful and the disease progressed, leading to external and internal nasal deformation and necessitating further excision and facial reconstruction. Histopathological analysis of the second biopsy revealed Splendore-Hoeppli changes consistent with a fungal infection. Microbiological findings subsequently confirmed Conidiobolus coronatus. Subsequently, the patient was successfully treated with a combination of itraconazole and fluconazole. To the best of the authors' knowledge, this is the first report of a case of rhinofacial conidiobolomycosis from the UAE.

Keywords: Antifungal Agents; Case Report; Conidiobolus; Nasal Obstruction; United Arab Emirates; Zygomycosis.

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Figures

Figure 1
Figure 1
Imaging of a 42-year-old male patient with excessive nasal bleeding and a suspected nasal tumour. A & B: Computed tomography scans confirming the intact nasal bony wall (arrows). C: Magnetic resonance imaging showing increased T2 signals in the nasal cavity alone (arrow), without intracranial spread or extension to the sinuses.
Figure 2
Figure 2
Endoscopic photograph of the nasal cavity of a 42-year-old male patient showing the spread of a highly vascularised mass to both the nasal mucosa and vestibular skin, indicating subcutaneous fat involvement. NS = nasal mucosa; VS = vestibular skin.
Figure 3
Figure 3
Photograph of a nasal mass culture showing multiple, flat, white, glabrous, slightly powdery-to-granular and radially furrowed colonies of fungus with several peripheral satellite colonies.
See this image and copyright information in PMC

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