A Rhinofacial Conidiobolus coronatus Fungal Infection Presenting as an Intranasal Tumour

Sultan Qaboos Univ Med J. 2018 Nov;18(4):e549-e552. doi: 10.18295/squmj.2018.18.04.022. Epub 2019 Mar 28.

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Conidiobolus / pathogenicity
  • Humans
  • Male
  • Mycoses / diagnosis*
  • Mycoses / drug therapy
  • Mycoses / physiopathology
  • Nasal Cavity / abnormalities
  • Nasal Cavity / physiopathology
  • Neoplasms / diagnosis
  • Neoplasms / physiopathology
  • Tomography, X-Ray Computed / methods
  • United Arab Emirates
  • Zygomycosis / diagnosis*
  • Zygomycosis / physiopathology

Substances

  • Antifungal Agents
  • Amphotericin B