All are true about Rhinoscleroma, except
?
a) Mikulicz cells
b) Caused by fungus
c) More common in Northern area
d) Woody nose
Correct Answer - B
Ans. is ‘b’ i.e., Caused by fungus
Rhinoscleroma is caused by a bacterium.
Rhinoscleroma
The causative organism is Klebsiella rhinoscleromatis or Frisch
bacillus, which can be cultured from the biopsy material.
The disease is endemic in several parts of world.
In India, it is seen more often in northern than in the southern parts.
Biopsy shows infiltration of submucosa with plasma cells,
lymphocytes, eosinophils, Mikulicz cells & Russell bodies.
The latter two are diagnostic features of the disease.
The disease starts in the nose & extends to nasopharynx,
oropharynx, larynx, trachea & bronchi.
Mode of infection is unknown.
Both sexes of any age may be affected.
Clinical features of rhinoscleroma
The disease runs through the following stages :?
a. Atrophic stage : It resembles atrophic rhinitis and is
characterised by foul smelling purulent nasal discharge and crusting.
b. 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.
c. Cicatricial stage : This causes stenosis of nares, distortion of
upper lip, adhesions in the nose, nasopharynx and oropharynx.
There may be subglottic stenosis with respiratory distress.
Biopsy of rhinoscleroma shows infiltration of submucosa with plasma
cells, lymphocytes, eosinophils, Mikulicz cells and Russell bodies.
The latter two are the diagnostic features of the disease.
Treatment
Both streptomycin & tetracycline are given together for minimum of
4-6 wks. Steroid can be combined to reduce fibrosis. Surgical
treatment may be required to establish the airway and correct nasal
deformity