Maneksha Velu, Aparna K S, Kavya Setty, Debaruna Ghosh
Department of Orbit and Oculoplasty, Aravind Eye Hospital, Tirunelveli, Tamilnadu, India.
Ophthalmic Plast Reconstr Surg. 2023;39(5):454-457. doi: 10.1097/IOP.0000000000002348. Epub 2023 Mar 27.
To describe the clinical profile of lacrimal sac rhinosporidiosis and to introduce a method for preoperative microbial identification of rhinosporidiosis using Gram stain.
This is a prospective study, carried out from January 2016 to January 2022. This series included 18 patients with clinical suspicion of lacrimal sac rhinosporidiosis. All patients underwent a comprehensive eye check-up. Mucopurulent discharge collected by a sterile swab after applying pressure over the sac area and Gram staining was done. All patients underwent dacryocystectomy. The sac contents were sent for histopathology, and rhinosporidiosis was confirmed.
A total of 18 patients over a period of 6 years with suspicion of lacrimal sac rhinosporidiosis were included. There were 11 (61.1%) male patients. Ten patients (55.5 %) had a history of either regular or occasional bathing in stagnant water. Nontender doughy swelling over the lacrimal sac region was the most common presentation. Gram staining of the mucopurulent discharge revealed thick-walled sporangia with endospores suggestive of rhinosporidiosis in all these cases. All patients underwent dacryocystectomy. Hematoxylin and eosin sections confirmed the diagnosis. Two patients had recurrence within 6 months after surgery.
Regurgitation of pus mixed with whitish granular particles or blood is highly suspicious of rhinosporidiosis. In clinically suspected cases, microbial diagnosis using Gram stain is an economical, office procedure, which helps the surgeon to plan for the surgery and for better counseling.
描述泪囊鼻孢子虫病的临床特征，并介绍一种使用革兰氏染色进行鼻孢子虫病术前微生物鉴定的方法。
这是一项前瞻性研究，于2016年1月至2022年1月进行。该系列包括18例临床怀疑为泪囊鼻孢子虫病的患者。所有患者均接受了全面的眼部检查。在泪囊区域施压后，用无菌拭子收集黏液脓性分泌物并进行革兰氏染色。所有患者均接受了泪囊摘除术。将囊内容物送去做组织病理学检查，确诊为鼻孢子虫病。
在6年期间共纳入18例怀疑泪囊鼻孢子虫病的患者。男性患者有11例（61.1%）。10例患者（55.5%）有定期或偶尔在死水中沐浴的病史。泪囊区无痛性面团样肿胀是最常见的表现。所有这些病例中，黏液脓性分泌物的革兰氏染色显示有厚壁孢子囊和内生孢子，提示为鼻孢子虫病。所有患者均接受了泪囊摘除术。苏木精和伊红切片确诊了诊断。2例患者在术后6个月内复发。
脓液与白色颗粒状物质或血液混合反流高度怀疑为鼻孢子虫病。在临床疑似病例中，使用革兰氏染色进行微生物诊断是一种经济的门诊操作，有助于外科医生规划手术并进行更好的咨询。
