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rhinoscleroma
Gram negative rod infection of the nose extending to the larynx.
Etiology: Klebsiella rhinoscleromatis
Epidemiology:
- endemic in Central & South America, south & central Europe, Egypt & southwest Asia
Pathology:
- tissue hematoxylin & eosin stain
- foamy macrophages with intracytoplasmic bacilli [2]
- plasma cells with Russell bodies [2]
- Warthin-Starry stain
- intracellular Klebsiella rhinoscleromatis
Clinical manifestations:
- mass growing in the central region of face, involving nose & upper lip (case report) [2]
- bilateral nostril obliteration
- palate infiltration
- loss of upper teeth
Laboratory:
- culture of tisuue fragments for Klebsiella
Differential diagnosis:
- other conditions that cause central facial destruction include:
- giant-cell carcinoma
- natural killer T-cell lymphoma
- granulomatosis with polyangiitis
- tuberculosis
- leprosy
- leishmaniasis
- blastomycosis
- cryptococcosis
- syphilis
Management:
- ciprofloxacin
- plastic surgery referral
General
otorhinolaryngologic disease; ear, nose & throat (ENT) disease
bacterial infection
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 108
- Castanedo Cazares JP1, Martinez Rosales KI
Images in Clinical Medicine. Rhinoscleroma.
N Engl J Med. 2015 Jun 18;372(25):e33
PMID: 26083225
http://www.nejm.org/doi/full/10.1056/NEJMicm1411602