Author(s)
Dayanira Trinidad, MD
Laura X. Barrios, MD
Irene L. Ibarra, MD
Alaide Caballero, MD
Andres Sanchez, MD
Teresa Gonzalez, MD
Affiliation(s)
Universidad Autonoma del Estado de Mexico, ISSEMyM Tlalnepantla
Abstract:
Introduction: Rhinoscleroma is a chronic infectious granulomatous disease of the upper respiratory tract that mainly affects the nasal mucosa. It is caused by Klebsiella rhinoscleromatis subspecies of Klebsiella pneumoniae. There are 3 stages of the disease: catarrhal, granulomatous and sclerotic.Objective: To present our clinical experience during 19 years, with 8 cases of rhinoscleroma and to corroborate the findings with the international literature.Methods: A retrospective study was performed from January 1994 to December 2013, looking for patients with rhinoscleroma and we analyzed their medical records.Results: A total of 8 patients with rhinoscleroma were included, 5 women and 3 men. The mean age was 43 years. Rhinoscleroma is endemic in some areas of Mexico and is associated with low socioeconomic status. The nose was affected in all the patients. The common clinical features were crusts, purulent rhinorrhoea, purulent post nasal drip and frontal headache. Treatment options for our patients were Fluoroquinolone, third-generation cephalosporin, Rifampicin, Trimethoprim/ sulfamethoxazole and aminoglycoside-containing nasal irrigations with variable results.Conclusions: Late diagnosis of rhinoscleroma leads to increased morbidity. The treatment should be individualized with antibiotics or surgery. Patients treated with Fluoroquinolone and/or Third-generation cephalosporin had better outcomes than with Rifampicin and Trimethoprim/ sulfamethoxazole.