Long-term follow-up of laryngeal Rhinosporidium seeberi diagnosed by PCR and treated with laser ablation and voriconazole nebulization in a retired thoroughbred polo horse.

A 21-year-old retired polo Argentinian thoroughbred horse from a teaching herd was presented for a routine bronchoalveolar lavage demonstration, during which an incidental finding of a granulomatous mass on the dorsal aspect of the epiglottis was made. Rhinosporidium seeberi was suspected from a histological section obtained from an initial biopsy, and the mass was removed via laser surgery for cytology and PCR. Sequencing of the PCR amplicons confirmed the diagnosis of R. seeberi. A treatment protocol of nebulized voriconazole for 10 d postoperatively was used. Long-term follow-up required 2 more laser surgeries plus oral fluconazole to resolve the remaining fungal spores. However, 2.5 y later, there was no evidence of remaining fungal spores. Key clinical message: Horses from endemic regions can potentially be exposed to R. seeberi. Based on its travel history, this horse may have contracted the infection in South America, California, or Alberta. Treatments administered, including diode laser resection, voriconazole antifungal nebulization, and oral fluconazole administration, were successful but required repeated interventions.

Suivi à long terme du Rhinosporidium seeberi laryngé diagnostiqué par PCR et traité par ablation au laser et nébulisation au voriconazole chez un cheval de polo thoroughbred pur-sang à la retraiteUn cheval thoroughbred argentin de polo retraité de 21 ans, issu d'un troupeau d'enseignement, a été présenté pour une démonstration de lavage broncho-alvéolaire de routine, au cours de laquelle une découverte fortuite d'une masse granulomateuse sur la face dorsale de l'épiglotte a été faite. Rhinosporidium seeberi a été suspecté à partir d'une coupe histologique obtenue à partir d'une biopsie initiale, et la masse a été retirée par chirurgie au laser pour cytologie et PCR. Le séquençage des amplicons PCR a confirmé le diagnostic de R. seeberi. Un protocole de traitement au voriconazole nébulisé pendant 10 jours après l'opération a été utilisé. Le suivi à long terme a nécessité 2 autres interventions chirurgicales au laser et du fluconazole oral pour éliminer les spores fongiques restantes. Cependant, 2,5 ans plus tard, il n'y avait aucune trace de spores fongiques restantes.Message clinique clé:Les chevaux des régions endémiques peuvent potentiellement être exposés à R. seeberi. D'après ses antécédents de voyage, ce cheval pourrait avoir contracté l'infection en Amérique du Sud, en Californie ou en Alberta. Les traitements administrés, notamment la résection au laser à diode, la nébulisation antifongique au voriconazole et l'administration orale de fluconazole, ont été efficaces mais ont nécessité des interventions répétées.(Traduit par Dr Serge Messier).

Nasal Rhinosporidiosis: Clinical Presentation, Clinical Findings, and Outcome in Dogs.

The purpose of this study was to describe the clinical presentation, imaging findings, and outcome in 10 dogs diagnosed with Rhinosporidium seeberi infections. Histopathology and cytology records were searched at a veterinary teaching hospital and a veterinary diagnostic laboratory to identify dogs with rhinosporidiosis. Medical records were reviewed for clinical, imaging, endoscopic, and surgical findings. Outcome was determined via evaluation of records and, where possible, telephone conversation with the primary care veterinarian and/or owner. Young to middle-aged large-breed dogs with an approximately equal sex distribution were represented. Unilateral signs predominated. Diagnosis was confirmed by histopathology in 9 cases, and cytology was diagnostic in only 1 of 3 cases. Histopathology was superior to cytology. Masses were soft tissue and contrast enhancing with no evidence of bony lysis on computed tomography (2 dogs). Direct or rhinoscopic (2 dogs) visualization revealed white to yellow pinpoint foci. Surgical resection (4 dogs) can result in long-term disease-free periods (up to 2659 days), although repeat surgery can be required. Dapsone was well tolerated in 1 dog, and relapse was not noted despite incomplete surgical resection (follow-up 749 days). Visualization of pale foci on a rostral intranasal mass in an endemic region should prompt consideration of rhinosporidiosis.

Rhinosporidiosis in horses / Rinosporidiose em equinos

Rhinosporidiosis is a disease caused by Rhinosporidium seeberi, an aquatic protist of the class Mesomycetozoa. It primarily affects the nasal mucosa and transmission is associated with contaminated water contact. This report describes seven cases of rhinosporidiosis in horses in Rio Grande do Sul covering the period of 13 years. The disease predominantly affected Crioulo and thoroughbred horses. No apparent gender predisposition occurs, and age ranged from two to 25 years, with a median of 10 years. The gross aspects were characterized by unilateral (85.7%, 6/7) or bilateral (14.3%, 1/7) polyps. These were soft to friable, whitish to pink, cauliflower-like, with an irregular, sometimes ulcerated surface, measuring 2.5 to 6.0cm in diameter. There was a severe inflammatory infiltrate of the submucosa was observed, associated with moderate proliferation of the epithelium, and numerous rounded structures were identified compatible with sporangia of R. seeberi. Rhinosporidiosis should be included in the differential diagnosis of other conditions affecting the respiratory tract of horses, and it is important to perform histopathology for diagnosis.(AU)

A rinosporidiose é uma doença causada por Rhinosporidium seeberi, protista aquático da classe Mesomycetozoa. Acomete principalmente a mucosa nasal e a transmissão está associada ao contato com água contaminada. Este trabalho descreve sete casos de rinosporidiose em equinos no Rio Grande do Sul em um período de 13 anos. A doença afetou predominantemente cavalos de raça, como Crioulo e Puro Sangue Inglês, sem predisposição sexual evidente e a idade variou de dois a 25 anos, com a mediana de 10 anos. Macroscopicamente foram caracterizadas por pólipos unilaterais (85,7%; 6/7) ou bilaterais (14,3%; 1/7). Os pólipos eram macios a friáveis, esbranquiçados a róseos, com aspecto de couve flor e com superfície irregular, por vezes ulcerada, medindo 2,5 a 6,0cm de diâmetro. Havia infiltrado inflamatório piogranulomatoso acentuado na submucosa associado à moderada proliferação do epitélio e numerosas estruturas arredondadas compatíveis com esporângios de R. seeberi. A rinosporidiose deve ser incluída no diagnóstico diferencial de outras patologias que acometem o trato respiratório de equinos, sendo importante a realização da histopatologia para diagnóstico.(AU)

Rhinosporidiosis in African reed frogs Hyperolius spp. caused by a new species of Rhinosporidium.

We report the identification of a new Rhinosporidium species (Dermocystida, Mesomycetozoea) infecting amphibian hosts, while showing a species specificity for African reed frogs of the genus Hyperolius. Large dermal cysts (sporangia) of R. rwandae sp. nov. were observed in 18% of H. lateralis and similar cysts in 0.7% of H. viridiflavus surveyed. Fully developed R. rwandae cysts are about 500 to 600 µm in diameter and sealed from the frog tissue by a thick chitinous wall. Some cysts were filled with numerous round-oval basophilic microspores of 8 to 12 µm diameter. With the exception of legs, nodules were visible over the complete torso surface including the vocal sac of males, but the most affected skin region was the area around the cloaca. Behavior, condition, and lifespan of infected frogs do not seem to be distinct from that of healthy individuals. The mode of infection remains unknown, but we hypothesize that the infectious life stage reaches the dermis via the intraepidermal ducts of the skin glands. Molecular evidence places the new frog pathogen as a sister species of the human pathogen R. seeberi.

Equine laryngeal rhinosporidiosis in western Canada.

A 12-year-old female Argentinean Warmblood mare was evaluated because of respiratory noise. The horse resided in Calgary, Alberta, Canada, but had been imported from Argentina 28 months prior to presentation. Endoscopy of the upper respiratory tract revealed a single polypoid mass on the left arytenoid. The mass was surgically excised and was diagnosed histologically as rhinosporidiosis. Polymerase chain reaction and DNA sequencing were used to confirm the etiological agent. Four weeks postoperatively, endoscopy was repeated, revealing recurrence of the original lesion with multiple additional polypoid masses on the larynx and in the oropharynx. Resolution of the disease had not been attained at the time of publication. The current report outlines a case of rhinosporidiosis in an unusual anatomical and geographic location. The infection most likely originated in Argentina, with a prolonged subclinical phase. Due to increased travel of human beings and animals, there is potential for the introduction of exotic diseases into nonendemic areas.

Concurrent nasal adenocarcinoma and rhinosporidiosis in a cat.

A 10-year-old, neutered, male Domestic Shorthair cat was presented to the teaching hospital for labored breathing, anorexia, and weight loss of several months duration. External examination revealed distortion of the bridge of the nose and pink fleshy polyps protruding from each nostril. The cat was euthanized and submitted for postmortem examination. In addition to the external findings, the nasal cavity had extensive bone and cartilage loss and contained a tan firm mass in the caudal region of the nasal cavity near the cribriform plate. On histologic examination, the mass was a nasal adenocarcinoma, and the polyps were composed of hyperplastic nasal epithelium and submucosal stroma that contained sporangia consistent with Rhinosporidium seeberi.

Nasal rhinosporidiosis in a mule.

A mass was removed from the nostril of a mule that exhibited unilateral epistaxis and nasal discharge. Impression smears revealed oval structures consistent with spores of Rhinosporidium seeberi. Microscopically, the mass was composed of fibrovascular granulomatous tissue containing sporangia R. seeberi. Surgical excision and antifungal treatment proved curative.

Cytologic identification of immature endospores in a dog with rhinosporidiosis.

An 8-year-old, intact, male Labrador Retriever was presented to the Boren Veterinary Medical Teaching Hospital at Oklahoma State University with a 2-month history of severe sneezing episodes that resulted in epistaxis and bilateral sanguineous discharge. Rhinoscopy revealed a small polypoid mass, and specimens were obtained for histopathology. Microscopic examination of formalin-fixed tissue specimens revealed organisms consistent with Rhinosporidium seeberi. The mass was surgically excised and impression smears were made for cytology examination. Smears revealed high numbers of endospores, typical of those previously described for R seeberi. In addition, numerous smaller structures, presumed to be immature endospores, were noted. The immature endospores were morphologically distinct from mature endospores and have not been described previously. Recognition of immature forms of Rhinosporidium may help prevent misidentification of the organism or misdiagnosis of a dual infection.

Rhinosporidiosis in a cat.

A polypoid nasal mass from an adult cat was submitted for routine biopsy examination and was found to contain sporangia and sporangiospores consistent with Rhinosporidium seeberi. Inflammatory infiltrates were moderate and pyogranulomatous to lymphohistiocytic and were associated with hyperplasia of the transitional nasal epithelium. Apparently, this is the first reported case of rhinosporidiosis in a cat.

Rhinosporidiosis in a domestic cat.

Rhinosporidiosis was diagnosed in a domestic shorthair cat from a suburb of Washington DC, USA. The clinical presentation of protracted sneezing and epistaxis was associated with a polypoid lesion in the right nostril. Light microscopic examination revealed a polypoid lesion with numerous sporangia containing maturing endospores. Free endospores were present in the stroma of the polyp and lumen of the nasal cavity. Transmission electron microscopy revealed ultrastructural features typical of Rhinosporidium seeberi. The case was followed clinically for a total of 70 months and there were five attempts at surgical excision. This is the first reported case of rhinosporidiosis in a domestic cat.

Nasal rhinosporidiosis in dogs: four cases from Europe and a review of the literature.

This paper describes four cases of canine rhinosporidiosis which occurred in Italy in 1994 and 1995. Four dogs with a history of exposure to the muddy environment of rice fields, developed respiratory signs. Rhinoscopy revealed nasal polypoid lesions with a characteristic gross appearance due to the presence of multiple, tiny, white-yellowish spots representing sporangia filled with spores. In cytological samples obtained by brushing, many spores were present in an inflammatory background. Histologically, the polyps consisted of fibrovascular tissue embedding sporangia in different developmental stages, and free spores which elicited a severe pyogranulomatous inflammation. All the dogs were treated surgically and the condition did not recur in two cases during a year's follow-up and in the other two cases during two years.

Rhinosporidiosis: a description of an unprecedented outbreak in captive swans (Cygnus spp.) and a proposal for revision of the ontogenic nomenclature of Rhinosporidium seeberi.

Rhinosporidiosis is a mucocutaneous zooanthroponotic disease caused by Rhinosporidium seeberi, a fungal-like organism of uncertain classification with an unknown mode of transmission. Over a 3 year period, 41 captive swans (Cygnus olor and C. atratus) developed conjunctival and cutaneous polypoid lesions diagnosed as rhinosporidiosis by histopathological examination including light and electron microscopy. Investigation of this avian outbreak, the first of its kind, provides additional insight into the epidemiology of this enigmatic aetiologic agent, which has yet to be isolated and cultivated in vitro. The occurrence of rhinosporidiosis in swans supports an aquatic environment as the reservoir for R. seeberi, which is often associated with exposure to water. We report the first known occurrence of rhinosporidiosis in 41 captive mute (C. olor) and Australian black (C. atratus) swans dwelling on a lake in a Central Florida city. Additionally, we review the development stages of R. seeberi and propose a revision in its ontogenic nomenclature to reflect its probable taxonomic classification as a member of the kingdom Fungi.

Canine rhinosporidiosis in Arkansas.

Rhinosporidiosis is a fungal infection caused by Rhinosporidium seeberi, a microorganism of complicated, undetermined life cycle. Many species of animals are susceptible to rhinosporidiosis, including human beings. The frequency of occurrence of the disease in domestic animals is unknown. A one-year-old male Collie dog from Northeast Arkansas was found to have rhinosporidiosis presenting as an intranasal polypoid mass. We believe this is the first documented report of rhinosporidiosis from the State of Arkansas.

Nasal rhinosporidiosis in the dog.

Rhinosporidiosis was diagnosed in six dogs from the southeastern United States. All six dogs had unilateral nasal polyps with multiple small white sporangia visible beneath the surface. Microscopically, the polyps consisted of organisms and fibrovascular tissue with a surface of columnar or squamous epithelium. Juvenile sporangia were unilamellar, 15-75 microns in diameter, nucleated, and accounted for about 65% of sporangia seen. Approximately 5% of the sporangia were in intermediate stages of maturation, were bilamellar, 100-150 microns in diameter, and contained immature endospores. Mature sporangia comprised about 30% of the total, were usually unilamellar, 100-400 microns in diameter, and contained a mixture of immature and mature endospores. The inner layer of the wall of the intermediate sporangia and the single wall of the mature sporangia were argyrophilic and carminophilic. Ultrastructurally, the earliest stage contained a nucleus and many ribosomes, lipid droplets, and phagolysosomes. Maturing sporangia contained discrete membrane-bound, round clevage products. These structures subsequently matured to spores, each of which had a wall and contained a nucleus and many lipid droplets. The organism from one dog was cultured and grown in vitro for 7 months and is the first successful cultivation of Rhinosporidium seeberi.

Rhinosporidiosis in a dog.

Rhinosporidiosis was diagnosed in a black and tan coonhound. Clinical signs were characterized by 6 to 8 months of intermittent sneezing. Numerous polypoid nodules were removed from the nasal cavity. Histologic examination of the nodules revealed chronic pyogranulomatous inflammation caused by infection with Rhinosporidium seeberi. Rhinosporidiosis has been reported in human beings, dogs, and several other domestic species. It is an uncommon disease in the United States.