Report of a case of giant rhinoscleroma: CT and MRI

Abstract

Rhinoscleroma is a chronic granulomatous bacterial infection caused by the gram-negative bacillus Klebsiella rhinoscleromatis . It predominately involves the nasal cavities but it can also involve the rest of the upper respiratory tract. Hypertrophic stage of rhinoscleroma may cause large tumor masses which could mimic neoplasm. Radiological imaging is essential for differentiation of rhinoscleroma from other granulomatous and malignant lesions. Imaging is also an important tool for detection of disease extensions and follow up post therapy. We illustrate the radiographic features of a patient with a giant rhinoscleroma using CT, MRI and CT virtual bronchoscopy for prompt diagnosis, assessment of disease extensions before therapy and follow up after therapy. The diagnosis was confirmed by tissue biopsy and culture. The patient received medical antibiotic treatment for 3 months after surgical excision of the lesion.

Rhinoscleroma: a diagnosis not to be ignored

“…It was based on streptomycin, rifampicin, sulfonamides and clofazimine [6]. The efficacy of fluoroquinolones has been demonstrated in our management.However, surgery in addition to medical treatment seems to be necessary especially in this case [7].…”