Sultan Qaboos University Medical Journal (Mar 2019)

A Rhinofacial Conidiobolus coronatus Fungal Infection Presenting as an Intranasal Tumour

  • Levente Deak,
  • Savitha Mudalagiriyappa,
  • Annelyse Ballin,
  • David Saxton,
  • Arunaloke Chakrabarti

DOI
https://doi.org/10.18295/squmj.2018.18.04.022
Journal volume & issue
Vol. 18, no. 4
pp. 549 – 552

Abstract

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