Ocular Rhinosporidiosis in a Nigerian Child: A Case Report and Literature Review from Niger Delta of Nigeria

Aim: The aim of this report is to raise the awareness of the existence of this rare ocular affliction in our locality and to highlight the importance of routine histopathological diagnosis of ocular mass lesions.
Case Presentation: An 11 year old male school child presented to our centre with a 9 months history of a fleshy growth which bleeds spontaneously, on the inner aspect of the right upper eyelid. Other parts of both eyes including the left eye lid were normal A provisional diagnosis of squamous cell papilloma of the conjunctiva was made and the patient underwent an excisional biopsy of the lesion. Microscopic sections of the mass showed hyperplastic polypoid lesion with numerous globular cysts within the subepithelia conjunctiva with a surrounding of heavy inflammatory reaction composed of lymphocytes, plasma cells and neutrophils. A histopathological diagnosis of conjunctival rhinosporidiosis was made.
Discussion: Rhinosporidiosis is a chronic localized granulomatous infection caused by an aquatic protistan parasite called Rhinosporidum seeberi. Ocular rhinosporidiosis is worldwide in distribution but to our knowledge, no case has been reported from Nigeria. Ocular rhinosporidiosis is presumably acquired through contact of the causative organism to traumatized epithelium usually in an aquatic habitat. It is said to be more common in those who dive or swim in stagnant water and those engaged in riverside sand dredging may be the mode of infection in this case.
It presents as a vascular friable polypoid growth as in this case. Although a few cases of nasal rhinosporidiosis have been reported from different parts of Nigeria, documented cases of ocular rhinosporidiosis from our centres are lacking. We herein report the first case of ocular rhinosporidiosis in Nigeria, from Bayelsa State, Niger Delta which presented as a fleshy mass in the palpebral conjunctiva in an 11year old boy.
Conclusion: Most conjunctiva mass lesions may mimic rhinosporidosis. A histopathogical diagnosis is therefore imperative.