Symptoms vary rapidly, perhaps even by the hour, and there is a rapid return to the premorbid state of health." A frequently quoted authority on BD, P. Pichot (Hôpital Sainte Anne, Paris) provides this description of BD: 

sudden onset: a bolt from the blue. manifold delusions without recognizable structure and cohesiveness with/without hallucinations. clouding of consciousness associated with emotional instability. absence of physical signs. rapid return to pre-morbid level of functioning.Pichots criteria can be refined further with these typical clinical characteristics: 

age: usually between 20 and 40 years of age. onset: acute without prior mental illness (with the exception of previous episodes of bouffée délirante). past history: no chronic mental disturbance after resolution of the BD episode. typical symptoms: delusions and/or hallucinations of any type. Depersonalization/derealization and/or confusion
depression and/or elation. symptoms quite variable from day to day and even hour to hour. not due to alcohol, drug use, or organic mental disorder. Formal classification
In 1968 the French national organization INSERM (Institut National de la Santé et de la Recherche Médicale) classification of mental illness referenced two types of BD in their category acute delusional psychoses and confusional states viz. reactive bouffée délirante and bouffée délirante (Magnans type). This classification scheme has been largely replaced by the two nosological systems discussed below.
Rhinosporidiosis is an infection caused by Rhinosporidium seeberi. Classification
This organism was previously considered to be a fungus, and rhinosporidiosis is classified as a fungal disease under ICD-10. It is now considered to be a protist classified under Mesomycetozoea.Authors of detailed studies have revealed superficial similarities between Dermocystidium and Rhinosporidium when using light microscopy, but substantial morphological differences between the groups exist.There is some evidence that DNA extracted from purified uncontaminated round bodies (Rhinosporidium seeberi) is of cyanobacterial origin. Pathophysiology
Rhinosporidiosis is a granulomatous disease affecting the mucous membrane of nasopharynx, oropharynx, conjunctiva, rectum and external genitalia. Though the floor of the nose and inferior turbinate are the most common sites, the lesions may appear elsewhere too. Traumatic inoculation from one site to others is common. Laryngeal rhinosporidiosis, too, has been described and may be due to inoculation from the nose during endotracheal intubation. After inoculation, the organism replicates locally, resulting in hyperplasia of host tissue and localised immune response.