Rhinoscleroma Research Paper

Abstract:
Rhinoscleroma is an uncommon chronic granulomatous disease of the upper airways affecting nasal cavity, nasopharynx, larynx, trachea and bronchi. The oral cavity, paranasal sinuses, soft tissues of the lips and nose can also be affected. We report a case of a 30 year old man suffering from nasal obstruction with septal deviation due to a mass in right upper lip & philtrum. The histopathological examination revealed granulation tissue with plasma cells and Mikulicz’s cells.
Keywords: Rhinoscleroma, Mikulicz’s cells, Russell bodies.
Background:
Rhinoscleroma is a chronic bacterial infection caused by Klebsiella rhinoscleromatis a Gram-negative, non-motile, encapsulated bacillus. Due to the low infectivity of the bacteria chronic exposure is required in order to establish infection. Rhinoscleroma is more frequent in the developing world like India. It’s likely to be a secondary complication as a result of underdeveloped hygiene, infrastructures, poor access to antibiotics and overcrowded living conditions.

The histological findings of Mikulicz cells, Russell bodies and positive Warthin-Starry stains are more characteristic and diagnostic in the proliferative stage. The catarrhal stage has no specific features that a pathologist can recognize. If clinically suspected a nasal swab for culture on Mac-Conkey agar to isolate the microorganisms would confirm the diagnosis. [9] Differentials to keep in mind include bacterial causes such as tuberculosis, actinomycosis and leprosy which can produce granulomas in the upper airways. Fungal infections including histoplasmosis, blastomycosis and sporotrichosis should also be considered. Other differentials consist of mucocutaneous leishmaniasis, malignancy such as lymphomas, inflammatory lesions such as sarcoidosis and wegener’s granulomatosis.