Rhinosclcroma is recognized more frequently now because of the recent influx of immigrants from endemic Central America. This chronic infectious disease presents with three overlapping clinical stages and can involve any part of the respiratory tract. A review of the clinical presentation leads to a patient evaluation plan consisting of physical examination and radiographic studies. A highly sensitive and specific method is introduced for identification of Klebsiella rhinoscleromatis in the biopsy specimen using the immunoperoxidase technique. A study of the immune status of the patient revealed general immunological competence except in effective phagocytosis of the organism by the Mikulicz cells. The choice of chronic antibiotic therapy should be guided by individual patient consideration with respect to age and sex. Repeat biopsies help determine the duration of antibiotic therapy. Relapses do occur and close observation is the key to long‐term follow‐up of the patient.
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Case Reports erythromycin, vancomycin, clindarnycin, chloramphenicol, streptomycin, sulfadiazine, and lincomycin. ' The head and neck surgeon must be ever mindful of infectious complications in patients who have experienced trauma or surgical procedures involving the head and neck. A high index of suspicion combined with meticulous culture and histopathologic studies of biopsy specimens will permit accurate diagnosis and appropriate treatment of such complications. As this case report demonstrates, actinomycosis, previously known primarily as a cause of infection following oral trauma, can also complicate surgery of the aerodigestive tract even when perioperative prophylactic antibiotics are employed. CONCLUSIONActinomyces species, because of their unique culture requirements, morphologic characteristics, and varied clinical guises, may be overlooked as a cause of postoperative complications unless the physician remains alert to the possibility of such infection in unusual locations. A case report of such an unexpected infection is presented, and the literature is reviewed.Leprosy (Hansen's disease) is a chronic, systemic, granulomatous infection in man caused by the acid-fast organism Mycobacterium leprae, which has a predilection for the skin, the peripheral nervous system, and the mucosa of the upper respiratory tract. I. 2 The organism establishes a stable host-parasite relationship that is usually not fatal but that is potentially mutilating. M. leprae is an obligate intracellular bacillus that has never
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