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Patellar Involvement in Disseminated Rhinosporidiosis: A Case Report
Vinod Kumar Balakrishna Pillai1, Nikhil Zacharia George, Sreejith Sreenivasan
1Deparment of Orthopaedics, Government TD Medical College Alappuzha, Kerala, India.
Case:
A 54-year-old man with disseminated rhinosporidiosis presented with chronic knee swelling. Examination revealed a patellar mass, later confirmed as Rhinosporidium seeberi infection, which is likely the first such case reported in the orthopaedic literature.
Conclusion:
Diagnosing a R. seeberi infection in the patella is challenging because of its erosive nature, which can mimic chondrosarcoma. Clinicians should maintain a high degree of suspicion, as this is a highly vascular lesion that may require preoperative angioembolization.
Insights
This case report details a rare instance of Rhinosporidium seeberi infection in a patient's patella, presenting as chronic knee swelling. Early diagnosis is crucial due to its potential to mimic bone cancer.
Area of Science:
- Orthopaedic Surgery
- Infectious Diseases
- Pathology
Background:
- Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi.
- It commonly affects the nasal mucosa and oral cavity, but disseminated and bone involvement is rare.
- Patellar masses due to infection are not well-documented in orthopaedic literature.
Purpose of the Study:
- To report a unique case of Rhinosporidium seeberi infection presenting as a patellar mass.
- To highlight the diagnostic challenges and clinical implications of this rare presentation.
- To increase awareness among orthopaedic surgeons regarding this unusual manifestation.
Main Methods:
- A 54-year-old male patient presented with chronic knee swelling and a palpable patellar mass.
- Diagnostic workup included physical examination and imaging (details not provided in abstract).
- Biopsy and histopathological examination confirmed Rhinosporidium seeberi infection of the patella.
Main Results:
- The patient was diagnosed with disseminated rhinosporidiosis with a specific presentation in the patella.
- The patellar mass was confirmed to be caused by Rhinosporidium seeberi.
- This represents a potentially novel case in the orthopaedic literature.
Conclusions:
- Rhinosporidium seeberi infection of the patella can present insidiously with chronic swelling.
- The erosive nature of the infection can mimic malignant bone tumors like chondrosarcoma.
- High clinical suspicion and awareness are necessary for timely diagnosis and management, potentially involving preoperative angioembolization due to the lesion's vascularity.
