Conidiobolomycosis: A Frequently Ignored Condition Highlighted by Two Case Reports
By
Kulasinghe Arachchige Chethana Charitha Pemasiri
Buddhika Ushani Manukulasooriya
Amal T. G. Fernanado
Ravindra Kirihena
Primali Irosha Jayasekera
February 16, 2026
Clinical Scorecard: Conidiobolomycosis: A Frequently Ignored Condition Highlighted by Two Case Reports
At a Glance
Category Detail
Condition Localized subcutaneous fungal infection caused by Conidiobolus species Key Mechanisms Inhalation or introduction of fungal spores to nasal mucosa leading to granulomatous inflammation Target Population Immunocompetent individuals with outdoor or agricultural exposure Care Setting Tertiary care centers with access to histopathology and antifungal therapy
Key Highlights
Conidiobolomycosis presents as chronic, painless, firm nasal swelling with nasal obstruction and possible facial disfigurement. Diagnosis is confirmed by histopathology showing broad aseptate fungal hyphae with granulomatous inflammation and eosinophilic infiltrates. Treatment with itraconazole and saturated potassium iodide leads to complete resolution with good tolerance and monitoring. Guideline-Based Recommendations
Diagnosis
Consider conidiobolomycosis in patients with chronic nasal obstruction and firm nasal swelling, especially with outdoor exposure. Use contrast-enhanced CT to assess soft tissue involvement and exclude bone or sinus invasion. Confirm diagnosis by histopathological examination of biopsy samples with fungal stains (e.g., Grocott–Gomori–Methamine silver stain). Management
Initiate antifungal therapy with itraconazole 200 mg twice daily. Adjunctive treatment with saturated potassium iodide solution thrice daily may be used. Continue treatment for at least 1-2 months after complete symptom resolution. Monitoring & Follow-up
Regularly monitor liver function tests during itraconazole therapy. Monitor thyroid function when using potassium iodide solution. Assess clinical response and resolution of nasal swelling and obstruction. Risks
Potential mild gastrointestinal side effects from itraconazole. Risk of liver toxicity necessitating regular liver function monitoring. Untreated infection may lead to severe facial disfigurement. Patient & Prescribing Data
Immunocompetent adults with chronic nasal swelling and outdoor exposure
Itraconazole combined with potassium iodide is effective and well tolerated; treatment duration extends beyond symptom resolution to prevent relapse.
Clinical Best Practices
Maintain high suspicion for conidiobolomycosis in patients with chronic nasal swelling and outdoor exposure history. Obtain biopsy for histopathological confirmation before initiating antifungal therapy. Use combined antifungal and potassium iodide therapy with close monitoring of liver and thyroid function. Follow patients until complete clinical resolution and continue treatment for an additional month to ensure cure. Related Resources & Content
