Rhinoscleroma

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Rhinoscleroma
A 14-year-old girl from El Salvador with rhinoscleroma
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Nasal obstruction, rhinorrhea, epistaxis, dysphonia, dyspnea
Complications	Airway obstruction, nasal deformity
Onset	Gradual
Duration	Chronic
Types	N/A
Causes	Klebsiella rhinoscleromatis
Risks	Poor hygiene, immunosuppression, endemic in certain regions
Diagnosis	Biopsy, culture
Differential diagnosis	Wegener's granulomatosis, sarcoidosis, leprosy, tuberculosis
Prevention	N/A
Treatment	Antibiotics (e.g., ciprofloxacin, tetracycline), surgery
Medication	N/A
Prognosis	Variable, can be chronic
Frequency	Rare
Deaths	N/A

Rhinoscleroma - very high magnification

Rhinoscleroma is a chronic granulomatous infection that primarily affects the nasal mucosa. It is caused by the bacterium Klebsiella rhinoscleromatis. The disease is characterized by the formation of granulomatous lesions in the nose, which can extend to the upper respiratory tract and mouth.

Etiology

Rhinoscleroma is caused by the bacterium Klebsiella rhinoscleromatis. This bacterium is a gram-negative, non-motile, encapsulated rod that is part of the Enterobacteriaceae family.

Epidemiology

Rhinoscleroma is endemic in certain parts of Central and South America, Africa, Eastern Europe, and Asia. It is most commonly seen in individuals between the ages of 10 and 30. The disease is more prevalent in rural areas and in populations with poor sanitation and hygiene.

Clinical Presentation

The disease typically presents with nasal obstruction, rhinorrhea, and epistaxis. As the disease progresses, it can lead to deformity and destruction of the nasal cartilage and bone. In severe cases, it can extend to the upper respiratory tract and mouth, causing dysphonia, dysphagia, and respiratory distress.

Diagnosis

Diagnosis of rhinoscleroma is based on clinical presentation, histopathological examination, and microbiological culture. The histopathological examination typically shows granulomatous inflammation with the presence of Mikulicz cells and Russell bodies.

Treatment

Treatment of rhinoscleroma involves a combination of surgical debridement and long-term antibiotic therapy. The antibiotics of choice are rifampin, ciprofloxacin, and doxycycline.

Prognosis

The prognosis of rhinoscleroma is generally good with appropriate treatment. However, the disease can cause significant morbidity due to its chronic nature and potential for causing deformity and destruction of the nasal and upper respiratory tract structures.

See Also

• Granuloma
• Klebsiella
• Nasal obstruction
• Rhinorrhea
• Epistaxis