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[Rhinoscleroma: a case report]
1Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Ludwig-Maximilians Universität München.
Background:
Rhinoscleroma is a rare infectious disease of the upper respiratory tract caused by Klebsiella rhinoscleromatis. The nasal mucosa represents the primary region of occurrence which is most likely a result of respiratory transmission. Without adequate++ treatment, the disease can potentially spread to the rest of the upper and middle respiratory tract within a period of several years. Healing often occurs with extensive scarring and adhesions of the nose, palate and larynx. A life threatening late stage manifestation includes subglottic stenosis requiring immediate surgical intervention. Medical treatment primarily consists of a long-term course of antibiotics. Ciprofloxacin (Fluoroquinolon) has proved to be one of the most effective drugs.
Case Report:
We report about a 33 year-old Egyptian male, who presented in our department with a 10 year history of a previously, only temporarily successfully treated rhinoscleroma. His main symptoms were nasal obstruction, epistaxis and inspiratory stridor.
Findings:
We began treatment with Ciprofloxacin over a four week period, which lead to an improvement of his symptoms. The treatment was considered complete after several biopsies and smears were negative for live specimens. We then chose to reduce the scar tissue that was causing obstruction in the larynx and the nose.
Conclusion:
The rhinoscleroma is a rare disease in geographic areas with poor hygiene and can mimic several other infectious and malignant diseases. Treatment should include a long-term antimicrobial therapy and surgical intervention in cases with symptomatic obstruction.
Insights
Rhinoscleroma, a rare upper respiratory infection, requires long-term antibiotic treatment, such as ciprofloxacin, and potentially surgery for severe obstruction. This case highlights effective management of this chronic condition.
Area of Science:
- Otorhinolaryngology
- Infectious Diseases
Background:
- Rhinoscleroma is a rare bacterial infection of the upper respiratory tract caused by Klebsiella rhinoscleromatis.
- It primarily affects the nasal mucosa and can spread, leading to scarring and potentially life-threatening subglottic stenosis.
Observation:
- A 33-year-old male presented with a 10-year history of rhinoscleroma, experiencing nasal obstruction, epistaxis, and inspiratory stridor.
Findings:
- Four weeks of ciprofloxacin treatment improved symptoms, with negative biopsies confirming treatment completion.
- Surgical intervention was performed to reduce laryngeal and nasal scar tissue causing obstruction.
Implications:
- Rhinoscleroma can mimic other diseases, necessitating accurate diagnosis in endemic areas.
- Effective treatment involves long-term antibiotics and surgical management for obstructive symptoms.
