Rhinoscleroma: An unusual presentation

Malkud, Shashikant; Mahajan, Pradeep

doi:10.4103/idoj.idoj_134_17

Cited by 9 publications

(2 citation statements)

References 11 publications

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“…Cases of RS have been reported throughout the upper and lower airway with cutaneous, nasal, laryngeal, maxillary, temporomandibular joint, palate, upper lip, anterior cranial fossa, and tracheal involvement across case reports and series. 6 Of these sites, the nasopharynx is most common, with the larynx and trachea being less common sites. 7 A review of the literature found 27 cases of RS with involvement of the larynx, trachea, and/or bronchi reported in the United States.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment regimens vary, but include rifampin and trimethoprim, ciprofloxacin and doxycycline, ciprofloxacin and cotrimoxazole, and ciprofloxacin and sulfamethoxazole. 6 , 17 Antibiotic selection is often adjusted according to resistances and sensitivities to available agents. Surgical correction of tracheal lesions with endoscopic laser therapy can be used for symptomatic relief of obstruction.…”

Section: Discussionmentioning

confidence: 99%

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Nonendemic rhinoscleroma: An unusual manifestation of the trachea

Celidonio,

Bahethi,

Malhotra

et al. 2024

Laryngoscope Investig Oto

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ObjectivesRhinoscleroma is classically described as a chronic granulomatous disease caused by Klebsiella rhinoscleromatis which primarily affects the nose and nasopharynx. When present, tracheal manifestations will be seen late in the disease course rather than on initial presentation. We describe a rare case of nonendemic rhinoscleroma that presented with tracheal lesions as an initial manifestation of disease.MethodsCase report and literature review.ResultsAn 88‐year‐old male presented with longstanding dysphonia. Flexible laryngoscopy demonstrated a septal perforation and diffuse glottic lesions. CT neck demonstrated a nonobstructive polypoid tracheal lesion and mucosal thickening of the paranasal sinuses. Biopsy confirmed an atypical lympho‐histiocytic proliferation and microorganisms within macrophages on Grocott methenamine silver and Steiner stains consistent with rhinoscleroma. He was referred for rheumatology and pulmonology consultation.ConclusionSystemic diseases rarely affect the trachea, and even less frequently is a tracheal lesion identified as the initial manifestation of disease. The most common systemic diseases that affect the trachea include relapsing polychondritis, granulomatosis with polyangiitis, amyloidosis, and inflammatory bowel disease. The literature surrounding nasolaryngotracheal rhinoscleroma is limited, especially in nonendemic areas. It is necessary to include unusual etiologies of airway lesions in the differential diagnosis, which warrants comprehensive airway evaluation including biopsy.Level of Evidence4.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%