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