Rhinoscleroma

Last Updated: 2019-08-27

Author(s): Anzengruber, Navarini

  • Kaposi und Hebra 1870.

Disease caused by Klebsiella rhinoscleromatis; an immobile, gram-negative rod.

Today endemic especially in young (20-35th year) patients in Asia, Africa and South America.

  • Pathogen: Klebsiella (pneumoniae) rhinoscleromatis
  • Transmission: Human to human by means of droplet infection.
  • A trigger for the infection might be lack of hygiene. The Klebsiellae phagocytized by the immune system cannot be killed, whereby the granulomatous defence reaction destroys the infected tissue.
  • Rhinitis, fetal nasal secretion with otherwise dry mucous membrane.
  • This is followed by crust formation with inflammatory, hard infiltrates (nose, upper lip and throat) and granulation of the upper lip.
  • Clinic.
  • Dermatopathological protection.
  • Detection of pathogens by bacterial culture.
  • Serological determination of Klebsiellen antibodies.
  • Since the pathogen is infectious and pathogenic for mice, an animal experiment is described.
  • Diagnostic guidance through infectiology.

Nose, oral mucosa and upper respiratory tract.

In the middle corium inflammation with plasma cells, Mikulicz cells and Russell bodies.

  • Surgical removal of all sclerotic infiltrates or nodes

Topical therapy

  • Nasal sprays containing glucocorticoids (e.g.: Nasonex 2x daily 1 stroke or Pulmicort Topinasal 2x daily 1 stroke).
  • Antiseptic compresses.

Systemic therapy

  • Ciprofloxacin p.o. 500 mg 2x per day for 8 weeks.
  • Alternative: Streptomycin IM 1 g per day for 6-8 weeks.
  • Alternative: Tetracycline p.o. 500 3x daily.
  • Alternative: Minocycline p.o. 100 mg 2x per day over 6 months.
  • Alternative: Cotrimoxazole p.o. 800/160 2x per day.
  • Alternative: Clofazimin p.o. initial 50-100 mg per day, maintenance therapy with 50 mg daily.
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  5. Tapia A. Rhinoscleroma: a naso-oral dermatosis. Cutis 1987;40:101-3.