Rhinoscleroma

• Granulomatous disease of the nose
• Causative organism
  • Klebsiella rhinoscleromatis
  • aka Frisch​​​​​​​ bacillus​​​​​​​
• More common in north India

• Mode of infection- unknown
• Disease starts in nose
• Spreads to
  • Nasopharynx, oropharynx
  • Larynx (mostly subglottic region)
  • Trachea and bronchi.

• Biopsy
  • Infiltration of submucosa with
    • plasma cells
    • lymphocytes
    • eosinophils
    • Mikulicz cells
    • Russell bodies
• Mickulicz cells
  • Large foam cells
  • Central nucleus
  • Vacuolated cytoplasm
  • Contains causative bacilli
• Russell bodies
  • Homogenous eosinophilic inclusion bodies found in the plasma cells

• Streptomycin (1g/day) +
• Tetracycline (2g/day)}

for 4-6weeks

• Treatment is only stopped when 2 consecutive cultures are negative ​​​​​​​

6th edition : Diseases of ENT & HN surgery

PL Dhingra, Shruti Dhingra

Page no :156-157

• Foul-smelling purulent nasal discharge
• Crusting

• Granulomatous nodules formed
  • Painless
  • Non-ulcerative
• Woody appearance of nose

• Stenosis of nares
• Distortion of upper lip
• Adhesions in
  • Nose
  • Nasopharynx
  • Oropharynx
•  Subglottic stenosis
  • May cause respiratory distress