Conidiobolomycosis | |
---|---|
Other names | Rhinoentomophthoromycosis[1] |
Conidiobolus coronatus[2] | |
Specialty | Infectious disease[3] |
Symptoms | Firm painless swelling in nose, sinuses, cheeks and upper lips, blocked nose, runny nose, nose bleed[4] |
Complications |
|
Usual onset | Slowly progressive[6] |
Duration | Long term[4] |
Causes | fungi of the genus Conidiobolus[4] |
Diagnostic method | Medical imaging, biopsy, microscopy, culture[5] |
Differential diagnosis | Soft tissue tumors,[4] Mucormycosis |
Treatment | Antifungals, surgical debridement[6] |
Medication | oral Itraconazole, topical Potassium iodide[6] Severe disease: intravenous Amphotericin B[5] |
Prognosis | Longterm morbidity: facial disfigurement,[4] good response to treatment[7] |
Frequency | Rare, M>F[4] adults>children[5] |
Deaths | Rare[6] |
Conidiobolomycosis is a rare long-term fungal infection that is typically found just under the skin of the nose, sinuses, cheeks and upper lips.[3][4] It may present with a nose bleed or a blocked or runny nose.[4] Typically there is a firm painless swelling which can slowly extend to the nasal bridge and eyes, sometimes causing facial disfigurement.[6]
Most cases are caused by Conidiobolus coronatus, a fungus found in soil and in the environment in general, which can infect healthy people.[4] It is usually acquired by inhaling the spores of the fungus, but can be by direct infection through a cut in the skin such as an insect bite.[3][4]
The extent of disease may be seen using medical imaging such as CT scanning of the nose and sinus.[4] Diagnosis may be confirmed by biopsy, microscopy, culture and histopathology.[4][5] Treatment is with long courses of antifungals and sometimes cutting out infected tissue.[6] The condition has a good response to antifungal treatment,[7] but can recur.[8] The infection is rarely fatal.[6]
The condition occurs more frequently in adults working or living in the tropical forests of South and Central America, West Africa and Southeast Asia.[4][5] Males are affected more than females.[4] The first case in a human was described in Jamaica in 1965.[4]
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