Abstract

Rhinofacial zygomycosis is a rare soft tissue fungal infection of the nasal and paranasal submucosa, and subcutaneous tissue of the face. It commonly affects immunocompetent adult male and may lead to facial disfigurement if left untreated. Diagnosis of rhinofacial zygomycosis is based on histopathological findings of the dense eosinophilic granular infiltrates with surrounding hyphal elements (Splendore-Hoeppli phenomenon), and/or positive culture of the causative organism – Conidiobolus coronatus or Conidiobolus incongruus. This case report is to highlight the rare entity of this disease and to illustrate the unusual presentation of chronic nasal congestion with painful inflamed rhinofacial swelling. To reach the diagnosis, a high index of suspicion with early tissue biopsy from the submucosa and subcutaneous region for histopathological and mycological examination if the patient does not response to the usual medical treatment. Prolonged systemic antifungal therapy with Amphotericin B, Itraconazole or Saturated solution of potassium iodide (SSKI) is the treatment of choice and the result is encouraging. However there is still no agreed consensus on the duration of the antifungal treatment. Future studies should be performed to determine the optimum antifungal treatment duration.

Key words: Rhinofacial zygomycosis, entomophthoramycosis, conidiobolomycosis, Conidiobolus coronatus