rhinoscleroma

Introduction

Gram negative rod infection of the nose extending to the larynx.

Etiology

Klebsiella rhinoscleromatis

Epidemiology

• endemic in Central & South America, south & central Europe, Egypt & southwest Asia

Pathology

• tissue hematoxylin & eosin stain
  • foamy macrophages with intracytoplasmic bacilli
  • plasma cells with Russell bodies
• Warthin-Starry stain
  • intracellular Klebsiella rhinoscleromatis

Clinical manifestations

• mass growing in the central region of face, involving nose & upper lip (case report)
• bilateral nostril obliteration
• palate infiltration
• loss of upper teeth

Laboratory

• culture of tisuue fragments for Klebsiella

Differential diagnosis

• other conditions that cause central facial destruction include:
  • giant-cell carcinoma
  • natural killer T-cell lymphoma
  • granulomatosis with polyangiitis
  • tuberculosis
  • leprosy
  • leishmaniasis
  • blastomycosis
  • cryptococcosis
  • syphilis

Management

• ciprofloxacin
• plastic surgery referral

More general terms

• otorhinolaryngologic disease; ear, nose & throat (ENT) disease
• bacterial infection