Rhinoentomophthoromycosis: An uncommon but not rare fungal infection of the nose

Entomophthoromycosis is a group of fungal infections caused by fungus belonging to the order Entomophthorales. The two clinical forms of entomophthoromycosis identified are Basidiobolomycosis and Conidiobolomycosis. Rhino-facial conidiobolomycosis mainly affects the mucosa of the nares, nasal passages, nasal sinuses, nasopharynx, mouth and spreads to adjacent tissues causing disfigurement of face. Histological examinations and mycological cultures are the gold standard for confirmation of entomophthoromycosis. In our middle aged female patient, histopathology revealed fungal elements with broad aseptate hyphae surrounded by splendor hoeppli material and surrounding tissue showed dense inflammatory infiltrate with numerous eosinophils and foreign body granulomatous reaction. Treatment include both surgical and medical management, which includes systemic antifungals. Patient was initiated on itraconazole to which she responded. A significant reduction in the swelling and restoration of patency of the nostrils was noted on review after one month. Knowledge of rare fungal infections such as entomophthoromycosis is significant in clinical practice.