Rhinofacial Conidiobolomycosis in a 16-Year-Old Girl

Abstract

Objectives : To present the case of a 16-year old girl with progressive facial disfigurement spanning 11 months due to Conidiobolomycosis.
 Methods: 
 Design: Case Report
 Setting: Tertiary Government Hospital
 Patient: One
 Results: A 16-year-old girl presented with a severe facial deformity of 11 months duration. The lesion started as a swelling in the right nasal vestibule, which later involved the entire nose, forehead, cheeks, upper and lower lip. A series of tissue biopsies revealed varied results -- chronic inflammation, chronic granulomatous inflammation with foreign body type giant cells, and eosinophilic granuloma—resulting in delayed provision of appropriate treatment. On the fourth biopsy using Grocott methenamine silver staining technique, septate fungal hyphae were identified. With a diagnosis of rhinofacial conidiobolomycosis, she was started on Itraconazole 100mg three times daily for eight months. Her facial swelling subsided gradually during the course of treatment and no systemic drug-related complications were observed.
 Conclusion: Rhinofacial conidiobolomycosis is a rare chronic localized fungal infection that usually affects midline facial structures in immunocompetent hosts. Early detection and diagnosis, and appropriate medication can give rapid resolution. To the best of our knowledge, this may be the first documented case of rhinofacial conidiobolomycosis in the Philippines.
 
 Keywords: Conidiobolomycosis; Conidiobolus; fungal infection; Itraconazole, Therapeutic use