Syn.: Rhinoscleroma.
Def .: Chronic respiratory tract infection.
Epid .: Endemic diseases in various parts of the world, mainly in the equatorial zone, more often in rural areas.
Etiol.: Klebsiella pneumoniae rhinoscleromatis.
Pat .: Infection mainly via air-droplet route. Bacterial capsular polysaccharides destroy the nasal mucosa with a granulomatous response.
Clinical: The infection is divided into stages: 1) chronic rhinitis with a foul-smelling odor; 2) scabs; 3) granular reaction, initially on the nasal septum; 4) nodular eruptions on the nostrils, upper lip, throat and larynx (Hebra’s nose); 5) fibrosis and destruction of bone structures. The changes are painless, but they change the voice and make it difficult to breathe.
Hist .: Chronic inflammation, plasma cells, Russell bodies, giant histiocytes containing mucin and bacteria (Mikulicz cells).
DL: Direct specimen or bacterial culture from affected tissues.
DR: Mucocutaneous leishmaniasis, paracoccidioidomycosis, blastomycosis, deep mycoses.
Healing: Surgical treatment of the focus, antibiotic therapy: tetracyclines (2 g / day for 6 months and 1 g / day for the next 6 months), ciprofl oxacin, trimethoprim together with sulfamethoxazole for 2-3 months.
Lit.: [1] Lenis A., Ruff T., Diaz JA and wsp.: Rhinoscleroma. 7South Med J 1988, 81(12); 1580-2 [2] Tapia A.: Rhinoscleroma: a naso-oral dermatosis. Cutis 1987, 40(2); 101-3
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House