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In Vivo Assessment of Alveolar Macrophage Efferocytosis Following Ozone Exposure
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Ozena in Immigrants of Differing Backgrounds.
Mallory J Yelenich-Huss1, Holly Boyer2, Jonathan D Alpern3
1Department of Surgery, University of North Dakota, Grand Forks, North Dakota.
The American Journal of Tropical Medicine and Hygiene
|April 27, 2016
Summary
Ozena, a chronic nasal condition, is often linked to Klebsiella infection. Early diagnosis and prolonged, culture-directed treatment are crucial for managing this rare disease and preventing severe complications.
Area of Science:
- Otolaryngology
- Infectious Diseases
Background:
- Ozena, also known as atrophic rhinitis, is a chronic nasal condition characterized by fetid discharge, crusting, and nasal atrophy.
- It is prevalent in Africa, India, and the Middle East, often associated with Klebsiella species infections.
Observation:
- This report details three unrelated cases of ozena with nasal Klebsiella infection.
- The cases involved two East African children and one Saudi adult, presenting with varying disease stages and diagnostic timelines.
Findings:
- All patients exhibited Klebsiella species in nasal cultures.
- Treatment required a multimodal approach, including antibiotics, saline rinses, and surgical debridement, with prolonged management durations.
Implications:
- Ozena is infrequently diagnosed in the United States and is prone to misdiagnosis.
- Delayed or inadequate treatment can result in irreversible sequelae, including anosmia, sinus and skull base destruction, and significant social impact.
- Clinicians must maintain a high index of suspicion for atrophic rhinitis and implement culture-directed, prolonged therapy with diligent follow-up.
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