Rhinoscleroma

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Rhinoscleroma

  • Rhinoscleroma
    • 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.
    • Diagnosis
      • 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.
    • Treatment
      • 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.
Rhinoscleroma nodules
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
Rhinoscleroma.wmv
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