NOSE - Rhinoscleroma

What is Rhinoscleroma?                 
 Rhinoscleroma is a progressive granulomatous disease of the nose, extending into the nasopharynx, oropharynx, larynx and rarely the trachea.

What is the Aetiology of rhinoscleroma?
Age     :           It can occur in any age.
Sex      :           Both sexes are equally affected
Race   :           It can affect people of any race.

Socioeconomic status:  It affects the patients staying in rural areas, with poor domestic hygiene.
Causative Organism: It is caused by the gram negative Frish bacillus, Klebsiella Rhinoscleromatis.

What is the Pathology of Rhinoscleroma?
The disease characterized by presence of granulations which infiltrate the submucosa with accumulation of plasma cells. A high presence of mucopolysaccharides around the virus may be responsible for protection of the organism against antibiotics and patients own antibodies.
Symptoms:
(1) Nasal Blockage
(2) Nasal Discharges
(3) Externally visible woody shape and feel of nose

 

Signs:
Nose is firm and woody

Anterior Rhinoscopy:
(a) Atrophic stage: Foul smelling discharge with changes in the mucous membrane.
(b) Granulation stage: Non ulcerative bluish red, and pale hard rubbery nodules develop
(c) Cicatrizing stage: Adhesions and stenosis distort the normal anat

What is the treatment of Rhinoscleroma?

(1) Once the diagnosis is confirmed by biopsy, high dosage of antibiotics like tetracycline, chloramphenicol and streptomycin are given for 4-6 weeks.
(2) Local application of acriflavine solution over 6-8 weeks.
Surgical:  Surgical treatment can be used to re-establish the airway without any further atrophic changes.



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