Perplexity in Managing Coeval Existence of Granulomatous Disorders: A Case Report

Aim To report a rare occurrence of 2 granulomatous diseases in a patient. Background Rhinosporidiosis is common in certain parts of tropical countries but rare in other regions. The migration of people in search of opportunities has led to the spread of contagious diseases. Although tuberculosis is prevalent in India, we had to perform a GeneXpert analysis to prove that the granulomatous lymphadenitis was due to tuberculosis and not rhinosporidiosis. Case description This is a case of nasal rhinosporidiosis with tuberculous cervical lymphadenitis in a 40-year-old male. He underwent excision of the rhinosporidiosis lesion and was started on multidrug therapy for treatment. Conclusion and clinical significance We present a case of rhinosporidiosis coexisting with tuberculous cervical lymphadenitis in a patient, both of which are granulomatous diseases. Rhinosporidiosis can also cause lymphatic spread to regional lymphadenitis with features of granulomas in histopathology. We diagnosed 2 granulomatous diseases in this patient by confirming tuberculous lymphadenitis using the GeneXpert test. Treatment was newly formulated with multiple drugs to address both granulomatous diseases.