UNUSUAL CAUSE OF LUNG COLLAPSE - RHINOSPORIDIOSIS

: BACKGROUND Rhinosporidiosis is a granulomatous infection most commonly affecting the nasal mucosa and conjunctiva. Tracheo-bronchial involvement is extremely rare and is potentially life threatening. The disease is endemic in India and Sri Lanka. We report a rare case of lung collapse following tracheobronchial Rhinosporidiosis with coexisting nasal, nasopharyngeal and oropharyngeal lesions. These kind of cases may pose a challenge to radiologists while interpreting findings if not thought of. CASE 50 year old man,with cutaneous manifestations, history of recurrent polypectomy and progressive dyspnea with tracheostomy tube in situ. The patients airway was secured after removing fleshy mass of Rhinosporidiosis in operation theatre and imaging was done to reveal the extent of the lesion. CT imaging of chest plain and contrast revealed left upper lobe collapse with loculated pneumothorax. CT PNS showed soft tissue mass occluding the nasal cavities, nasopharynx and maxillary antrum. CT neck showed soft tissue mass in sub glottis and upper trachea. 5 months follow up imaging after surgical and Medical management with Dapsone 100mg bd showed complete resolution of the lung collapse with residual masses in the nasal cavity, maxillary antrum, nasopharynx, sub glottis and upper trachea.CONCLUSION Lung collapse caused by tracheo-bronchial seedling secondary to repeated nasal polypectomy is a rare manifestation.An awareness and understanding of the presence of rare manifestations in the diagnosis is essential, Whenever we see nasal Rhinosporidiosis, tracheobronchial Rhinosporidiosis should strongly be considered.