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Respiratory scleroma: a clinicopathologic and ultrastructural study
H O Sedano1, R Carlos, I G Koutlas
1School of Dentistry, University of Minnesota, Minneapolis, USA.
Summary
Respiratory scleroma, a chronic Klebsiella rhinoscleromatis infection, affects the respiratory tract. Histopathology reveals characteristic Mikulicz cells and plasma cell infiltrates in affected patients.
Area of Science:
- Infectious Diseases
- Pathology
- Microbiology
Background:
- Respiratory scleroma is a chronic granulomatous infection caused by Klebsiella rhinoscleromatis.
- The disease is endemic in several global regions and sporadically reported in the United States, often in migrants.
- While commonly affecting the nose, scleroma can extend to the palate, lips, and sinuses.
Purpose of the Study:
- To describe the clinical and histopathological findings of respiratory scleroma in a Guatemalan cohort.
- To characterize the ultrastructural features of the lesion.
- To advocate for the term "respiratory scleroma" due to its broader anatomical involvement.
Main Methods:
- Light microscopy examination of biopsy samples from 11 patients.
- Ultrastructural analysis of the lesional tissue.
- Clinical data collection over a 6-year period.
Main Results:
- Histopathology showed dense plasmacytic infiltrate, Mikulicz histiocytes, and Russell bodies.
- Ultrastructural study identified Mikulicz histiocytes, bacilli within cytoplasmic vacuoles, and A and B granules.
- The study included 11 patients (6 females, 5 males) aged 16-60 years.
Conclusions:
- Respiratory scleroma presents with distinct histopathological and ultrastructural features.
- The term "respiratory scleroma" accurately reflects the potential involvement of the entire respiratory tract and oral cavity.
- Further research may elucidate the pathogenesis and optimal management of this infection.