Rhinoscleroma

Abstract

Rhinoscleroma in nonendemic regions is extremely rare; however, with increased travel, immigration, and globalization, it is imperative to recognize this entity because the symptoms can be devastating and in some cases fatal. Although nasopharynx is the common site of involvement, unusual sites such as the trachea can be involved in rare cases. Rhinoscleroma can be managed effectively with a combination of antibiotics and surgical debridement and repair; however, recurrence rates do remain high.

Rhinoscleroma: A Rare Chronic Infectious Cause of Nasal Mass Lesions in the United States

“…2,7,9 Mikulicz cells are rarely identified in this stage. 2 Progression to the granulomatous stage occurs several months or years after initial infection. Histologically, the respiratory epithelium may be atrophic or show pseudoepitheliomatous hyperplasia.…”

“…It is caused by infection with the gram-negative, encapsulated bacillus Klebsiella rhinoscleromatis and is endemic to certain regions of Africa, Southeast Asia, Mexico, Central and South America, and Central and Eastern Europe. [1][2][3] The nasal cavity is the most frequently affected region, involved in 95% to 100% of reported cases, with the pharynx being the second most frequent site, involved in up to half of cases. [4][5][6][7] The pathogenesis, transmission, and risk factors of the disease are incompletely understood.…”

“…Progression to the granulomatous phase is often more symptomatic and is characterized by mass formation with local tissue destruction in some cases. 2 Patients may present with chronic, foul, purulent discharge, episodes of epistaxis, and nasal obstruction. The granulomatous stage may last for months to years, and most patients with rhinoscleroma are diagnosed during this stage.…”

“…The granulomatous stage may last for months to years, and most patients with rhinoscleroma are diagnosed during this stage. 2,6,7 If left untreated, rhinoscleroma may then progress to the sclerotic phase where nasal deformity, anosmia, oral anesthesia, dysphonia, dysphagia, and stridor may develop, depending on which areas of the respiratory tract are involved. Histological examination of biopsies taken during the catarrhal stage typically show nonspecific squamous metaplasia of the epithelium with underlying acute inflammation and granulation tissue.…”

Long‐standing laryngeal rhinoscleroma with rare Mikulicz cells

“…Rhinoscleroma typically affects the nasopharynx and upper respiratory tract; cases involving the larynx 1,2 and North American cases are rare. While classically associated with Klebsiella rhinoscleromatis , other Klebsiella species have also been implicated 3 .…”