- It is a chronic granulomatous disease
- caused by Gram-negative bacillus called Klebsiellarhinoscleromatis or Frisch bacillus.
- The disease runs through the following stages:
- Atrophic stage.
- It resembles atrophic rhinitis
- ischaracterised by foul smelling purulent nasal discharge and crusting.
- Granulomatous stage
- Granulomatous nodules form in nasal mucosa.
- There is also subdermal infiltration of lower part of external nose and upper lip giving a ‘woody’ feel
- Nodules are painless and non-ulcerative.
- Cicatricial stage.
- There may be subglottic stenosis with respiratory distress.
- Biopsy shows infiltration of submucosa with plasma cells, lymphocytes, eosinophils, Mikulicz cells and Russell bodies.
- Mikulicz cells and Russell bodies. arediagnostic features of the disease.
- Mikulicz cells
- largefoam cells with a central nucleus and vacuolated cytoplasm containing causative bacilli.
- Russell bodies
- homogenouseosinophilic inclusion bodies found in the plasma cells.
- They occur due to accumulation of immunoglobulins secreted by the plasma cells.
- Both streptomycin and tetracycline are given together for a minimum period of 4-6 weeks and repeated, if necessary, after 1 month
- Steroids can be combined to reduce fibrosis.
- Surgical treatment may be required to establish the airway and correct nasal deformity.
Rhinoscleroma atrophic changes
A chronic granuloma of the nose & larynx that may present with nasal crusts, loss of smell and offensive discharge.
A chronic granuloma of the nose & larynx that may present with nodules, nasal obstruction and discharge.
Practical patho Lymph nodes & Rhinoscleroma
3rd year medical school videos by Ainshams channel team