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Related Experiment Videos

Rhinoscleroma: eight Peruvian cases.

Ciro Maguiña1, Juan Cortez-Escalante, Fernando Osores-Plenge

  • 1Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru. cirom@upch.edu.pe

Revista Do Instituto De Medicina Tropical De Sao Paulo
|November 7, 2006
PubMed
Summary

Rhinoscleroma, a rare upper airway infection, can be misdiagnosed. Antibiotic treatment with ciprofloxacin or oxytetracycline showed success in Peruvian patients, though stenosis persisted.

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Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Dermatology

Background:

  • Rhinoscleroma is a rare granulomatous bacterial infection caused by Klebsiella rhinoscleromatis.
  • It predominantly affects the upper respiratory tract, particularly the nose and pharynx.
  • Geographic distribution includes Central Africa, South America, Eastern Europe, the Middle East, India, and Indonesia, often misdiagnosed in endemic areas.

Purpose of the Study:

  • To report cases of rhinoscleroma diagnosed and treated at a national hospital in Lima, Peru.
  • To highlight diagnostic challenges and the efficacy of antibiotic therapy for rhinoscleroma.
  • To document the long-term sequelae of upper airway stenosis following treatment.

Main Methods:

  • Retrospective case series of eight patients diagnosed with rhinoscleroma between 1996 and 2003.

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  • Clinical presentation, diagnostic methods (biopsy with Mikulicz cells), and treatment regimens were reviewed.
  • Patients received ciprofloxacin or oxytetracycline and were followed for 6-12 months.

    • Main Results:

    • Eight patients presented with structural airway alterations leading to nasopharyngeal, oropharyngeal, and laryngeal stenosis.
    • Biopsies confirmed rhinoscleroma by identifying characteristic Mikulicz cells (vacuolated macrophages).
    • Antibiotic treatment (ciprofloxacin or oxytetracycline) resulted in no active infection or relapse, but all patients had residual upper airway stenosis.

    Conclusions:

    • Rhinoscleroma diagnosis can be challenging, often confused with other granulomatous diseases.
    • Antibiotic therapy is effective in clearing the infection and preventing relapse.
    • Upper airway stenosis is a significant long-term complication requiring management even after successful infection treatment.