Conidiobolomycosis

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Conidiobolomycosis
Other namesRhinoentomophthoromycosis
nose bleed[4]
Complications
Usual onsetSlowly progressive
morbidity: facial disfigurement,[4] good response to treatment[7]
FrequencyRare, M>F[4] adults>children[5]
DeathsRare[6]

Conidiobolomycosis is a rare

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

insect bite.[3][4]

The extent of disease may be seen using

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]

Signs and symptoms

The infection presents with firm

bleed.[4]

Cause

Conidiobolomycosis is a type of

Entomophthoromycosis, the other being basidiobolomycosis, and is caused by mainly Conidiobolus coronatus, but also Conidiobolus incongruus and Conidiobolus lamprauges[4]

Mechanism

Conidiobolomycosis chiefly affects the central face, usually beginning in the nose before extending onto paranasal sinuses, cheeks, upper lip and pharynx.

insect bite.[3] Thrombosis, infarction of tissue and spread into blood vessels does not occur.[4] Deep and systemic infection is possible in people with a weakened immune system.[4] Infection causes a local chronic granulomatous reaction.[6]

Diagnosis

The condition is typically diagnosed after noticing facial changes.

fungal filaments with branching at right-angles.[5] There are only a few septae.[5] The fungus is fragile and hence rarely isolated.[1] An immunoallergic reaction might be observed, where a local antigen–antibody reaction causes eosinophils and hyaline material to surround the organism.[5] Molecular methods may also be used to identify the fungus.[5]

Differential diagnosis

Differential diagnosis includes soft tissue tumors.[4] Other conditions that may appear similar include mucormycosis, cellulitis, rhinoscleroma and lymphoma.[6]

Treatment

Treatment is with long courses of antifungals and sometimes

triazoles, preferably itraconazole.[5] A second choice is potassium iodide, either alone or combined with itraconazole.[5] In severe widespread disease, amphotericin B may be an option.[5] The condition has a good response to antifungal treatment,[7] but can recur.[8] The infection is rarely fatal but often disfiguring.[6]

Epidemiology

The disease is rare, occurring mainly in those working or living in the tropical forests of West Africa, Southeast Asia, South and Central America,[4] as well India, Saudi Arabia and Oman.[5] Conidiobolus species have been found in areas of high humidity such as the coasts of the United Kingdom, eastern United States and West Africa.[6]

Adults are affected more than children.[5] Males are affected more than females.[4]

History

The condition was first reported in 1961 in horses in Texas.[4] The first case in a human was described in 1965 in Jamaica.[4] Previously this genus was thought to only infect insects.[4]

Other animals

Conidiobolomycosis affects spiders, termites and other arthropods.[4] The condition has been described in dogs, horses, sheep and other mammals.[9] Affected mammals typically present with irregular lumps in one or both nostrils that cause obstruction, bloody nasal discharge and noisy abnormal breathing.[9]

References

  1. ^
    PMID 27904202
    .
  2. PMID 32273794
    .
  3. ^ a b c d "ICD-11 - ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Retrieved 5 June 2021.
  4. ^
    ISBN 978-93-86261-83-0
    .
  5. ^
    PMID 28774696
    .
  6. ^
    PMID 34033391
    .
  7. ^
    doi:10.7860/JCDR/2019/40142.12701
    .
  8. ^
    PMID 31763253
    .
  9. ^
    ISBN 978-1-4160-2406-4
    .

External links

Retrieved from "https://en.wikipedia.org/w/index.php?title=Conidiobolomycosis&oldid=1194416466"