Comparison of in vivo and in vitro inactivation of endospores of Rhinosporidium seeberi following dapsone treatment

Rhinosporidiosis in humans and animals, caused by Rhinosporidium seeberi, can now be termed an emerging infective disease worldwide. The pharmacokinetics of dapsone when used as an antimicrobial agent in patients with rhinosporidiosis was compared with its pharmacodynamics in the inactivation of purified rhinosporidial endospores in vitro. A marked discrepancy was noted between the in vitro inactivation, which commenced on day 1 and was a maximum at day 4, whereas earlier reports on the response of endospores in patients under dapsone therapy indicated that the degeneration and disappearance of the endospores was not observed for 18–36 weeks after therapy began. Reasons for this discrepancy that operate in vivo are postulated: (a) impermeability of the barriers of down-growths of squamous epithelium in which the endospore-containing rhinosporidial sporangia are embedded; (b) presence of a mucoid matrix in which the endospores exist within the sporangia. These explanations contribute to resolving the controversial problem of general correlations between in vitro and in vivo results from studies on the action of antimicrobial drugs.