RhinosclerosisA48.8

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 15.06.2022

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Synonym(s)

nasal scleroma; Rhinoscleroma

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HistoryThis section has been translated automatically.

v.Hebra, 1870

DefinitionThis section has been translated automatically.

Rare, chronic, bacterial (Klebsiella pneumoniae rhinoscleromatis - see Klebsiella below) infectious disease of the nose, oral mucosa and upper respiratory tract (Umphress B et al.).

PathogenThis section has been translated automatically.

Klebsiella pneumoniae subsp. rhinoscleromatis an immobile, encapsulated, Gram-negative rod. Transmission from person to person by droplet infection.

Occurrence/EpidemiologyThis section has been translated automatically.

China, India, Central Africa, Central and South America.

ManifestationThis section has been translated automatically.

Mainly occurring between the ages of 20 and 35.

Clinical featuresThis section has been translated automatically.

Rhinitic pre-stage with foetal nasal secretion, crusts, dry nasal and pharyngeal mucosa.

Later crusts and inflammatory hard infiltrates develop in the nasal mucosa, upper lip, pharynx and larynx.

Development of hard, reddish, painless, vegetative granulations with fusion to unshaped, nodular formations (Hebra- or tapir nose). The infectious granulomas can destroy adjacent bony structures. Undisturbed general condition.

HistologyThis section has been translated automatically.

Chronic inflammation in the middle corium. Dense accumulation of plasma cells, Russel corpuscles and Mikulicz cells.

DiagnosisThis section has been translated automatically.

Cultural detection of bacteria, if necessary animal experiments (mice).

Differential diagnosisThis section has been translated automatically.

Mucocutaneous leishmaniasis; South American blastomycosis; granuloma gangraenescens nasi; malignant tumours; syphilis III; leprosy; tuberculosis cutis luposa.

External therapyThis section has been translated automatically.

Sprayscontaining glucocorticoids such as Nasonex, budesonide nasal spray(e.g. Pulmicort Topinasal) 1 spray in each nostril in the morning and evening. Moist compresses with antiseptic additives such as quinolinol (e.g. Chinosol 1:1000) or potassium permanganate (light pink) on externally accessible affected skin areas.

Internal therapyThis section has been translated automatically.

Antibiosis e.g. with Ciprofloxacin 250-500mg p.o. over 6-8 weeks.

Alternatively Tetracycline (e.g. Tetracycline 500 Wolff 2-4 times/day 1 Kps.) or Minocycline (e.g. Mino-Wolff) 2 times/day 100 mg p.o. over 6 months.

Alternatively: Cotrimoxazol p.o. (e.g. Eusaprim® forte 3 times/day 1 tbl.).

Alternative: Clofazimine (e.g. Lamprene) initial 50-100 mg/day p.o., maintenance therapy with 50 mg/day (under maintenance dose of 50 mg practically no NW).

Operative therapieThis section has been translated automatically.

Removal of all sclerotic infiltrates or nodes is a prerequisite for subsequent drug therapy. Possibly also therapy with the CO2 laser after completion of the antibiotic therapy, if necessary reconstructive measures.

LiteratureThis section has been translated automatically.

  1. Hebra F v (1870) About a strange new formation on the nose - rhinoscleroma. Vienna Med Weekly 20: 1-4
  2. Kasper HU et al (2004) Rhinoscleroma associated with Rosai-Dorfman reaction of regional lymph nodes. Catholic Int 54: 101-104
  3. Umphress B et al (2018) Rhinoscleroma. Arch Catholic Lab Med 142:1533-1536.

Authors

Last updated on: 15.06.2022

Author: Prof. Dr. med. Peter Altmeyer