Rhinoscleroma is a chronic granulomatous infection involving the upper respiratory tract due to Klebsiella rhinoscleromatis. It initially involves the nasal mucosae but it may progress to any other part of the upper respiratory tract.
Untreated rhinoscleroma slowly progresses over many years 1.
Patients most often present with nasal obstruction. Other non specific symptoms are often encountered such as epistaxis, rhinorrhea, dysphagia, stridor and dysphonia.
Patients with rhinoscleroma are usually between 10 to 30 years old. Poor hygiene, prolonged close contact and malnutrition are considered risk factors. It is endemic in Central America, Egypt, tropical Africa, India, and Indonesia 3.
The main feature of rhinoscleroma is focal or diffuse tracheal wall thickening with or without nodularity. Hence, it also presents as subglottic stricture and narrowing of the trachea. The thickening is of soft-tissue density, without calcifications 1.
For a differential diagnosis, see :
- 1. Prince JS, Duhamel DR, Levin DL et-al. Nonneoplastic lesions of the tracheobronchial wall: radiologic findings with bronchoscopic correlation. Radiographics. 2002;22 Spec No : S215-30. Radiographics (link) - Pubmed citation
- 2. Tan SL, Neoh CY, Tan HH. Rhinoscleroma: a case series. Singapore Med J. 2012;53 (2): e24-7. Singapore Med J (link) - Pubmed citation
- 3. Fawaz S, Tiba M, Salman M et-al. Clinical, radiological and pathological study of 88 cases of typical and complicated scleroma. Clin Respir J. 2011;5 (2): 112-21. doi:10.1111/j.1752-699X.2010.00207.x - Pubmed citation