An 11-year-old female student from the province of Arauco, Bío-Bío Region, who lived on shores of Lanalhue Lake, with no history of travel outside the region.
The patient presented a one-month history characterized by a red, non-painful eye associated with bloody epiphora and blepharitis.
A conjunctivitis was diagnosed in the primary care polyclinic and 0.5% chloramphenicol was indicated in eye drops for 7 days, and then tobramycin with dexamethasone eye drops for 48 h.
The patient was referred to pathology due to treatment failure.
On examination, the visual acuity was 20/20.
A pseudomembrane was observed in the upper eyelid of the right eye, which was extracted and sent for biopsy.
Multiple follicles were observed in the rest of the conjunctiva; the cornea was infected.
The clinical diagnosis was adenovirus follicular conjunctivitis as the most probable etiology.
Histopathological study with hematoxylin and eosin staining showed a conjunctival mucosa with mild and focal irregular acanthosis.
The subepithelial connective tissue presented a moderate lymphoplasmacytic infiltrate, some blood vessels dilated with extravasation of red blood cells and numerous cystic formations of variable size, made up of an eosinophilic wall chitin.
Histopathological findings were compatible with conjunctival rhinosporidiosis.
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After surgical removal of the lesion and after five months of follow-up, the patient remained asymptomatic, with no evidence of recurrence.
