Rhinoscleroma
Rhinoplasty
Nasal Obstruction
Thiamphenicol
Klebsiella pneumoniae
MR appearance of rhinoscleroma. (1/24)
BACKGROUND AND PURPOSE: We describe the MR imaging appearance of rhinoscleroma, an endemic, chronic, granulomatous disease whose causative agent is Klebsiella rhinoscleromatis. METHODS: The study included 15 patients (nine males and six females; mean age, 25 years; range, 13-36 years) with rhinoscleroma. MR imaging was performed in all patients. The signal intensity of the nasal masses was compared with that of fat, muscle, and CSF on both T1- and T2-weighted images. All cases were proved by histopathologic examination. RESULTS: The nasal masses were bilateral and symmetrical (n = 6), asymmetrical (n = 4), or unilateral (n = 5). They extended through the anterior nares (n = 9) or posterior choana into the nasopharynx (n = 3). They obstructed the ostiomeatal units with retained secretions in the related sinuses (n = 10). On T1-weighted images, rhinoscleroma showed striking (n = 9) or mild (n = 6) high signal intensity relative to muscle and CSF, but less hyperintensity than fat. On T2-weighted images, the nasal masses showed homogeneous high signal intensity (n = 10) or heterogeneous high signal intensity associated with hypointense foci (n = 5). They were hyperintense relative to fat and muscle, but less hyperintense than CSF. CONCLUSION: The hypertrophic stage of rhinoscleroma has characteristic mild to marked high signal intensity on both T1- and T2-weighted MR images. (+info)Nasal rhinoscleroma in a nonendemic area: a case report. (2/24)
Rhinoscleroma is a chronic, granulomatous infectious lesion most frequently affecting the respiratory tract mucosa. This disease is endemic to Africa, Central and South America, South Central and Eastern Europe, the Middle East, and China. We report an extremely rare disease of nasal rhinoscleroma in Korea. The patient was a 63-yr-old man, who suffered from chronic nasal obstruction and septal deviation. Characteristic histology from a nasal biopsy was proven and special stains for bacteria were employed: periodic acid-Schiff, Warthin-Starry silver, Giemsa, and Gram stains. Isolation of Klebsiella rhinoscleromatis from a culture of nasal discharge was failed, but ultrastructural examination of numerous phagocyzed bacilli in the Mikulicz cells confirmed the diagnosis. The histiocytic nature of the Mikulicz cells was confirmed, using CD 68 and alpha-1 antitrypsin, and by the ultrastructural features of Mikulicz cells. Here, we emphasize the recognition of this rare entity in nonendemic regions, frequently leading to delayed diagnosis. (+info)Laser in the management of stenosing oropharyngeal scleroma. (3/24)
We present here our experience of laser for the management of stenosed oropharyngeal scleroma. The diagnosis of scleroma was made 14 years ago and the patient underwent repeated procedures like dilatation, diathermy excision of adhesions and cryosurgery during this period. He attended our out-patient department with complaints of dysphagia and difficulty in breathing, progressing to stridor. On examination, severe oropharyngeal stenosis due to cicatrization extending between the base of the tongue and the post-pharyngeal wall was seen. Using CO2 laser, cicatrix was released by making radial cuts and the oropharyngeal opening was widened. No tracheostomy was needed; no blood loss occurred and the patient was discharged on the next day. (+info)In vitro activities of streptomycin and 11 oral antimicrobial agents against clinical isolates of Klebsiella rhinoscleromatis. (4/24)
We tested in vitro the activities of streptomycin and tetracycline--antibiotics that have long been used to treat rhinoscleroma--as well as several newer oral agents by using 23 isolates of the causative organism Klebsiella rhinoscleromatis. All isolates were inhibited by clinically achievable concentrations of trimethoprim-sulfamethoxazole, amoxicillin-clavulanate, chloramphenicol, ciprofloxacin, cephalexin, cefuroxime, and cefpodoxime. (+info)Laryngeal scleroma associated with Klebsiella pneumoniae subsp. ozaenae. (5/24)
Klebsiella pneumoniae subsp. ozaenae was isolated from the pharynx of a woman with laryngeal scleroma. K. pneumoniae subsp. ozaenae is rarely isolated from clinical infections and has never been reported in laryngeal scleroma, which is usually caused by K. pneumoniae subsp. rhinoscleromatis. (+info)Rhinoscleroma: eight Peruvian cases. (6/24)
Rhinoscleroma is a rare infection in developed countries; although, it is reported with some frequency in poorer regions such as Central Africa, Central and South America, Eastern and Central Europe, Middle East, India and Indonesia. Nowadays, rhinoscleroma may be erroneously diagnosed as mucocutaneos leishmaniasis, leprosy, paracoccidioidomycosis, rhinosporidiasis, late syphilis, neoplasic diseases or other upper airway diseases. From 1996 to 2003, we diagnosed rhinoscleroma in eight patients attended in the Dermatologic and Transmitted Diseases service of "Cayetano Heredia" National Hospital, in Lima, Peru. The patients presented airway structural alterations producing nasopharyngeal, oropharyngeal and, in one patient, laryngeal stenosis. Biopsy samples revealed large vacuolated macrophages (Mikulicz cells) in all patients. Ciprofloxacin 500 mg bid for four to 12 weeks was used in seven patients and oxytetracycline 500 mg qid for six weeks in one patient. After follow-up for six to 12 months the patients did not show active infection or relapse, however, all of them presented some degree of upper airway stenosis. These cases are reported because of the difficulty diagnosing the disease and the success of antibiotic treatment. (+info)Rhinoscleroma: case report. (7/24)
Rhinoscleroma is a chronic, granulomatous infection that most frequently affects the respiratory mucosa, especially the nasal cavity and eventually extending through the lower respiratory tract. The disease is endemic in some countries of Central America (El Salvador and Guatemala), Indonesia, India, Poland, Hungary, Russia and some African countries as well. It is a rare disease in South America. We report a 51-year-old male resident of a psychiatric institution in Sao Paulo presenting with progressive nasal obstruction, frontal headache, yellowish nasal discharge and a mass extruding through the right nasal vestibule. The present case report describes a Rhino-Sinus scleroma where histopathology was vital in the diagnosis. The patient was treated by surgical excision of the nasal mass followed by a course of ciprofloxacin. He has remained asymptomatic up to the last visit six months following treatment and has shown no evidence of recurrence. (+info)Rhinoscleroma: a clinicopathological study from the Gulf region. (8/24)
INTRODUCTION: Rhinoscleroma is a chronic progressive inflammatory disease of the upper respiratory tract. We report a clinicopathological series from the Gulf region. METHODS: The clinical and pathological features of patients diagnosed with rhinoscleroma at three main hospitals in Saudi Arabia and Bahrain over a 20-year period are presented. Archived glass slides and paraffin blocks from these patients were retrieved from the pathology files for review. Special stains were performed whenever indicated. Biopsy material and clinical data from 25 patients formed the basis of this study. RESULTS: Most of the patients were young females with a median age of 24 years. The nose was involved in all cases with frequent extension to other parts of the upper respiratory tract. The provisional clinical diagnoses included syphilis, midline granuloma and malignancy. The histological differential diagnoses included leprosy, malakoplakia and metastatic renal cell carcinoma. CONCLUSION: Rhinoscleroma is rare in Saudi Arabia and Bahrain. Awareness of possible clinical presentations and early diagnosis will significantly reduce the morbidity caused by this disease. (+info)Rhinoscleroma is a chronic, granulomatous infection that primarily affects the nasal mucosa. It's caused by the bacterium Klebsiella rhinoscleromatis (formerly named Klebsiella pneumoniae subsp. rhinoscleromatis). The disease is characterized by the formation of firm, woody granulomas that can lead to destruction of the nasal structures and deformity of the nose if left untreated.
The infection typically progresses through three stages: catarrhal, granulomatous, and fibrotic. In the catarrhal stage, there is a persistent runny nose and nasal congestion. The granulomatous stage is characterized by the formation of nodules and plaques in the nasal passages, which can cause crusting, foul-smelling discharge, and difficulty breathing through the nose. In the fibrotic stage, the tissues of the nose become thickened, hardened, and scarred, leading to deformity and loss of function.
Rhinoscleroma is most commonly found in developing countries with poor socioeconomic conditions, particularly in tropical and subtropical regions. It's more prevalent in populations with limited access to healthcare and clean water, as well as those living in overcrowded conditions. The disease primarily affects young adults and children, and it has a slight female predominance.
Treatment for rhinoscleroma typically involves long-term antibiotic therapy using agents such as trimethoprim-sulfamethoxazole, tetracyclines, or fluoroquinolones. In some cases, surgical intervention may be necessary to remove scar tissue and restore nasal function. Preventive measures include improving living conditions, access to clean water, and early detection and treatment of the disease.
Rhinoplasty is a surgical procedure performed on the nose to reshape its structure or improve its function. This may involve altering the bone, cartilage, or soft tissues of the nose to change its appearance, straighten its bridge, reduce or increase its size, narrow its width at the nostrils, or change the angle between the nose and upper lip. It can also be done to correct birth defects, injuries, or help relieve breathing problems. The procedure is usually performed by an otolaryngologist (ear, nose, and throat specialist) or a plastic surgeon, and it requires a thorough understanding of nasal anatomy and function.
Nasal obstruction is a medical condition that refers to any blockage or restriction in the normal flow of air through the nasal passages. This can be caused by various factors such as inflammation, swelling, or physical abnormalities in the nasal cavity. Common causes of nasal obstruction include allergies, sinusitis, deviated septum, enlarged turbinates, and nasal polyps. Symptoms may include difficulty breathing through the nose, nasal congestion, and nasal discharge. Treatment options depend on the underlying cause and may include medications, surgery, or lifestyle changes.
Thiamphenicol is an antibiotic that belongs to the class of medications called amphenicols. It works by preventing the growth of bacteria. Thiamphenicol is used to treat various infections caused by bacteria. This medication may also be used to prevent bacterial endocarditis (inflammation of the lining of the heart and valves) in people having certain dental or surgical procedures.
Please note that this definition is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. If you have any questions about your medication, always consult with your healthcare provider.
"Klebsiella pneumoniae" is a medical term that refers to a type of bacteria belonging to the family Enterobacteriaceae. It's a gram-negative, encapsulated, non-motile, rod-shaped bacterium that can be found in various environments, including soil, water, and the gastrointestinal tracts of humans and animals.
"Klebsiella pneumoniae" is an opportunistic pathogen that can cause a range of infections, particularly in individuals with weakened immune systems or underlying medical conditions. It's a common cause of healthcare-associated infections, such as pneumonia, urinary tract infections, bloodstream infections, and wound infections.
The bacterium is known for its ability to produce a polysaccharide capsule that makes it resistant to phagocytosis by white blood cells, allowing it to evade the host's immune system. Additionally, "Klebsiella pneumoniae" has developed resistance to many antibiotics, making infections caused by this bacterium difficult to treat and a growing public health concern.
A nose, in a medical context, refers to the external part of the human body that is located on the face and serves as the primary organ for the sense of smell. It is composed of bone and cartilage, with a thin layer of skin covering it. The nose also contains nasal passages that are lined with mucous membranes and tiny hairs known as cilia. These structures help to filter, warm, and moisturize the air we breathe in before it reaches our lungs. Additionally, the nose plays an essential role in the process of verbal communication by shaping the sounds we make when we speak.