Radiological diagnosis of rhinoscleroma—the ‘Palatal Sign’

Dawlatly, E. E.

doi:10.1017/s0022215100117967

Cited by 12 publications

(3 citation statements)

References 6 publications

(6 reference statements)

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“…thickening of palate on radiology, has been mentioned. 3 The patient presented here had several unusual features, as mentioned in the introduction. As a result, the diagnosis eluded several clinicians for years, and this delay may have increased the morbidity substantially.…”

Section: Discussionmentioning

confidence: 57%

Palatal presentation of scleroma

Bhargava

Date

2001

J. Laryngol. Otol.

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A case with palatal presentation of scleroma is presented due to its rarity and unusual manifestations. The patient presented with only palatal symptoms. Nasal endoscopy revealed signs of all three stages of scleroma: catarrhal, granulomatous and sclerotic stages. Histopathology was vital in the diagnosis. The patient was treated by medical therapy, and palatal symptoms were relieved by uvulopalatopharyngoplasty.

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Section: Discussionmentioning

confidence: 57%

Palatal presentation of scleroma

Bhargava

Date

2001

J. Laryngol. Otol.

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“…As K. pneumoniae subsp. rhinoscleromatis is not considered as a commensal of the respiratory tract, its identification is key to the definitive diagnosis of the disease [12], [13]. This infectious agent is metabolically less versatile than other K. pneumoniae strains, but definitive identification based on biochemical properties (ONPG negative, no acid production from lactose, urease, LDC and citrate negative) is rendered difficult due to variation in metabolic characteristics of K. pneumoniae strains [9], [11].…”

Section: Introductionmentioning

confidence: 99%

PCR-Based Identification of Klebsiella pneumoniae subsp. rhinoscleromatis, the Agent of Rhinoscleroma

et al. 2011

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Rhinoscleroma is a chronic granulomatous infection of the upper airways caused by the bacterium Klebsiella pneumoniae subsp. rhinoscleromatis. The disease is endemic in tropical and subtropical areas, but its diagnosis remains difficult. As a consequence, and despite available antibiotherapy, some patients evolve advanced stages that can lead to disfiguration, severe respiratory impairment and death by anoxia. Because identification of the etiologic agent is crucial for the definitive diagnosis of the disease, the aim of this study was to develop two simple PCR assays. We took advantage of the fact that all Klebsiella pneumoniae subsp. rhinoscleromatis isolates are (i) of capsular serotype K3; and (ii) belong to a single clone with diagnostic single nucleotide polymorphisms (SNP). The complete sequence of the genomic region comprising the capsular polysaccharide synthesis (cps) gene cluster was determined. Putative functions of the 21 genes identified were consistent with the structure of the K3 antigen. The K3-specific sequence of gene Kr11509 (wzy) was exploited to set up a PCR test, which was positive for 40 K3 strains but negative when assayed on the 76 other Klebsiella capsular types. Further, to discriminate Klebsiella pneumoniae subsp. rhinoscleromatis from other K3 Klebsiella strains, a specific PCR assay was developed based on diagnostic SNPs in the phosphate porin gene phoE. This work provides rapid and simple molecular tools to confirm the diagnostic of rhinoscleroma, which should improve patient care as well as knowledge on the prevalence and epidemiology of rhinoscleroma.

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“…Bacterial culture (blood or MacConkey agar) is positive in c. 50% of cases [6]. Radiographic examination can also be of value to demonstrate the palatal sign [20], as can magnetic resonance imaging and computed tomography [21].…”

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confidence: 99%

Rhinoscleroma

Editors¹

2000

Journal of Medical Microbiology

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Rhinoscleroma or respiratory scleroma is a chronic progressive granulomatous infection that predominantly affects the upper airways. The infection is due to a capsulate gram-negative bacterium, Klebsiella rhinoscleromatis, which was ®rst described by Von Frisch in 1882 [1]. Descriptions of the disease pre-date this considerably. The earliest evidence of rhinoscleroma comes from terracotta head-masks dated to the Mayan civilisation somewhere between 300 and 600 AD [2]. These heads showed proliferative lesions of the nose rather than the ulcerative lesions that would be more suggestive of leishmaniasis. The ®rst clear report of rhinoscleroma was in 1870 and is attributed to Von Hebra and Kaposi who considered it to be a form of sarcoma [3]. However, Mikulicz subsequently and correctly ascribed the disease to an in¯ammatory process and described the de®nitive histopathological features [4]. In 1932, at the Second International Congress of Otorhinolaryngology in Madrid, it was suggested that the name of the disease be changed from rhinoscleroma to scleroma, as it affected not just the nose but anywhere in the upper airways. However, because of possible confusion between scleroma and systemic sclerosis or scleroderma, the old name rhinoscleroma or respiratory scleroma is still preferred.

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Radiological diagnosis of rhinoscleroma—the ‘Palatal Sign’

Cited by 12 publications

References 6 publications

Palatal presentation of scleroma

Palatal presentation of scleroma

PCR-Based Identification of Klebsiella pneumoniae subsp. rhinoscleromatis, the Agent of Rhinoscleroma

Rhinoscleroma

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