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Celidonio J, Bahethi R, Malhotra R, Sangappa S, Kaye R. Nonendemic rhinoscleroma: An unusual manifestation of the trachea. Laryngoscope Investig Otolaryngol 2024; 9:e1293. [PMID: 38974602 PMCID: PMC11222660 DOI: 10.1002/lio2.1293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/15/2024] [Accepted: 05/31/2024] [Indexed: 07/09/2024] Open
Abstract
Objectives Rhinoscleroma is classically described as a chronic granulomatous disease caused by Klebsiella rhinoscleromatis which primarily affects the nose and nasopharynx. When present, tracheal manifestations will be seen late in the disease course rather than on initial presentation. We describe a rare case of nonendemic rhinoscleroma that presented with tracheal lesions as an initial manifestation of disease. Methods Case report and literature review. Results An 88-year-old male presented with longstanding dysphonia. Flexible laryngoscopy demonstrated a septal perforation and diffuse glottic lesions. CT neck demonstrated a nonobstructive polypoid tracheal lesion and mucosal thickening of the paranasal sinuses. Biopsy confirmed an atypical lympho-histiocytic proliferation and microorganisms within macrophages on Grocott methenamine silver and Steiner stains consistent with rhinoscleroma. He was referred for rheumatology and pulmonology consultation. Conclusion Systemic diseases rarely affect the trachea, and even less frequently is a tracheal lesion identified as the initial manifestation of disease. The most common systemic diseases that affect the trachea include relapsing polychondritis, granulomatosis with polyangiitis, amyloidosis, and inflammatory bowel disease. The literature surrounding nasolaryngotracheal rhinoscleroma is limited, especially in nonendemic areas. It is necessary to include unusual etiologies of airway lesions in the differential diagnosis, which warrants comprehensive airway evaluation including biopsy. Level of Evidence 4.
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Affiliation(s)
- Joseph Celidonio
- Department of Otolaryngology—Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Rohini Bahethi
- Department of Otolaryngology—Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Raj Malhotra
- Department of Otolaryngology—Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Suchitra Sangappa
- Department of PathologyNewark Beth Israel Medical CenterNewarkNew JerseyUSA
| | - Rachel Kaye
- Department of Otolaryngology—Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
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Mukdad L, Romero SN, McCurdy D, Shapiro NL. Unusual Laryngotracheal Manifestation of Rhinoscleroma in a Pediatric Migrant Patient. OTO Open 2021; 5:2473974X211058677. [PMID: 34870060 PMCID: PMC8637720 DOI: 10.1177/2473974x211058677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/15/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Laith Mukdad
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Samira Nazzar Romero
- Department of Pediatric Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Deborah McCurdy
- Department of Pediatric Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Nina L Shapiro
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Tang L, Kim J, Gao WZ. Nasal Polyps, Multifocal Laryngeal Masses, and Subglottic Stenosis in a Middle-aged Man. JAMA Otolaryngol Head Neck Surg 2021; 146:302-303. [PMID: 31876942 DOI: 10.1001/jamaoto.2019.3904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Liyang Tang
- USC Voice Center, USC Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| | - Jeehong Kim
- USC Voice Center, USC Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| | - William Z Gao
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, and MedStar Washington Hospital Center, Washington, DC
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Romdhane N, Zoghlami I, Fradi R, Chiboub D, Nefzaoui S, Jouini R, Mbarek C. [Tracheal rhinoscleroma]. Med Mal Infect 2020; 50:623-624. [PMID: 32278063 DOI: 10.1016/j.medmal.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 11/24/2022]
Affiliation(s)
- N Romdhane
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - I Zoghlami
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - R Fradi
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - D Chiboub
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - S Nefzaoui
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - R Jouini
- Service d'anatomopathologie, hôpital Habib-Thameur, Tunis, Tunisie.
| | - C Mbarek
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
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Elwany S, Fattah HA, Mandour Z, Ismail AS, Abdelnabi M. A Myriad of Scleroma Presentations: The Usual and Unusual. Head Neck Pathol 2019; 14:588-592. [PMID: 31529285 PMCID: PMC7413941 DOI: 10.1007/s12105-019-01075-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/06/2019] [Indexed: 11/27/2022]
Abstract
To prospectively study a series of scleroma patients with a focus on socioeconomic status, clinical presentation, pathology, microbiology, and treatment. A total of 52 patients diagnosed with scleroma were included in the study. Demographic data of the patients were collected and clinical, radiographic, and histopathologic findings were analyzed. Biopsies from atypical patients were sent for electron microscopic examination. Patients were treated both medically and surgically with clinical follow-up to determine outcomes and the incidence of recurrence. Fifty-two patients were included in the study. There were 23 males (44.2%) and 29 females (55.8%). The highest incidence of scleroma was identified in individuals from poor, rural areas in the third to fourth decades of life. The nose was affected in all cases. Other affected sites included the nasopharynx, soft and hard palate, larynx and trachea, lacrimal passages, skin, and gingiva. Some patients had atypical presentations. Complete follow-up of all patients was hindered by non-compliance with clinic visits and the long duration of medical treatment. Recurrence or relapse of the granulomatous lesions after initial improvement occurred in 11 patients (21.2%) within 1 to 3 years. Scleroma is a stubborn, chronic, granulomatous bacterial disease. The diverse presentations may mimic neoplasms and other granulomatous conditions. We present cases with unusual presentations and demonstrate the transmission electron microscopic features of these lesions. Furthermore, we confirm the importance of achieving full eradication of the etiologic bacilli to prevent recurrent disease.
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Affiliation(s)
- Samy Elwany
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt.
| | - Hesham Abdel Fattah
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt
| | - Zeyad Mandour
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt
| | - Ahmed Soliman Ismail
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt
| | - Mostafa Abdelnabi
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt
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Abstract
Chronic laryngitis is an inflammatory process of at least 3 weeks duration and affects phonation, breathing, and swallowing. This article describes the infectious, inflammatory, and autoimmune causes of chronic laryngitis. Symptoms of chronic laryngitis are nonspecific and may range from mild to airway compromise requiring emergent tracheostomy.
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Extradural Hematoma With Unanticipated Difficult Intubation Due to Rhinoscleromatosis. J Neurosurg Anesthesiol 2017; 29:67-68. [DOI: 10.1097/ana.0000000000000385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gobel Y, Valette G, Delahaye L, Marianowski R. A case of laryngeal rhinoscleroma. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:215-6. [DOI: 10.1016/j.anorl.2015.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
BACKGROUND Scleroma is a rare, chronic, granulomatous infectious disease of the respiratory tract mucosa which begins in the nose and spreads to the respiratory tract and adjoining structures. We report on the extensions and the management of 134 cases of scleroma in the Highlands region of Papua New Guinea. METHODS The charts and treatment records of 134 scleroma cases were retrospectively reviewed from 1995 to 2013. The staging, extensions, treatment and results of treatment were reviewed and analysed. RESULTS Of the 134 cases, 72 (53.7%) were females and the age ranged from 6 to 65 years. The disease was confined to the nose and nasopharynx in 71 (53.0%) cases. Extension of the disease from the nose to the Eustachian tube occurred in nine (6.7%) cases and into the middle ear in four (3.0%) cases. Further extensions to the larynx and trachea were seen in 17 (12.7%) cases each and the bronchus in three (2.2%) cases. Primary laryngoscleroma without involvement of the nose and nasopharyngeal stenosis without laryngeal involvement were managed in 11 (8.2%) and nine (6.7%) cases respectively. Others cases treated were ethmoid scleroma with proptosis and scleroma involving the upper lip in one (0.75%) case each. Ninety-nine (74.9%) patients were treated medically while 35 (26.1%) patients required surgery. Cure were achieved in 83 (61.9%) cases treated medically and 26 (19.4%) had successful surgical outcome. CONCLUSION Scleroma begins in the nose and when not arrested, extends causing obstruction to the airway and cosmetic deformity which requires surgical intervention.
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Affiliation(s)
- Charles P Molumi
- Department of Ear, Nose and Throat, Port Moresby General Hospital, Boroko, Papua New Guinea
| | - Siba P Dubey
- Department of Ear, Nose and Throat, Port Moresby General Hospital, Boroko, Papua New Guinea.,School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
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The "forgotten zone": acquired disorders of the trachea in adults. Respir Med 2013; 107:1301-13. [PMID: 23669413 PMCID: PMC7125950 DOI: 10.1016/j.rmed.2013.03.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 03/14/2013] [Accepted: 03/26/2013] [Indexed: 12/22/2022]
Abstract
The upper airway is generally defined as the air passage segment that extends between the naso- or oropharynx and the carina. The longest segment of the upper airway—the trachea—begins at the inferior portion of the larynx and extends to the branch point of the main carina. The trachea has the potential to be a “forgotten zone” in differential diagnoses, as pathological processes involving this portion may not receive prominent clinical consideration in disorders presenting with respiratory symptoms and signs. Unlike the oropharynx, this anatomical area is beyond visualization on routine inspection; unlike the mediastinum and lung fields, it is a potential “blind spot” on initial, plain radiographic examination of the chest. Nonetheless, the adult trachea is affected by a number of primary disorders and is also a target organ of a variety of systemic diseases. This review will focus on both primary and systemic diseases involving the adult trachea with specific attention to their clinical manifestations and diagnostic hallmarks.
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Role of MR imaging in laryngoscleroma. Eur Arch Otorhinolaryngol 2012; 270:985-8. [DOI: 10.1007/s00405-012-2247-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 10/23/2012] [Indexed: 11/25/2022]
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Abstract
Rhinoscleroma is a chronic granulomatous condition of the nose and other structures of the upper respiratory tract. Infection by the bacterium Klebsiella rhinoscleromatis is said to be the cause. A female patient aged 45 years, presented with a past history of trauma to the nose and swelling on her nose since last 1 year. There was nasal asymmetry and internal nasal examination showed a septal swelling protruding to the right nasal cavity with hypertrophied nasal mucosa and inferior turbinate. Open tip rhinoplasty approach was used to excise the mass, which examined pathologically revealing a rhinoscleroma, fibrotic infiltrative stage.
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Affiliation(s)
- Mohamed A Shoeib
- Department of Plastic Surgery, Sohag Faculty of Medicine, Sohag, Egypt - 82542
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Al Alousi F, Al Soub H, Al Baker B. Rhinoscleroma of the Larynx: First case report in the State of Qatar. Qatar Med J 2011. [DOI: 10.5339/qmj.2011.1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Rhinoscleroma is a chronic slowly progressive inflammatory condition of the upper airways mostly caused by infection with Klebsiella pneumoniae subspecies rhinoscleromatis and less frequently subspecies ozaenae. The disease is uncommon in developed countries but it still exists in Africa and South America. The disease usually takes a chronic course and diagnosis, which might be delayed, depends on the isolation of the organism from the tissue and the characteristic histopathologic features. We report here a case of rhinoscleroma of the upper airways that presented as a laryngeal mass in a young Egyptian man living in Qatar. The methods of diagnosis and treatment are discussed and the relevant literature reviewed.
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Affiliation(s)
- F.H Al Alousi
- *Infectious Diseases Section, Department of Medicine
| | - H Al Soub
- **ENT Section, Surgery Department, Hamad Medical Corporation, Doha, Qatar
| | - B Al Baker
- *Infectious Diseases Section, Department of Medicine
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Zhong Q, Huang Z, Guo W, Zhang S, Ge W. Rhinoscleroma: case report. Am J Otolaryngol 2010; 31:381-3. [PMID: 20015775 DOI: 10.1016/j.amjoto.2009.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 04/01/2009] [Accepted: 04/06/2009] [Indexed: 11/16/2022]
Affiliation(s)
- Qi Zhong
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China
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Razek AAKA, Castillo M. Imaging appearance of granulomatous lesions of head and neck. Eur J Radiol 2009; 76:52-60. [PMID: 19501997 DOI: 10.1016/j.ejrad.2009.05.021] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Revised: 05/12/2009] [Accepted: 05/13/2009] [Indexed: 11/29/2022]
Abstract
We aim to review the imaging appearance of granulomatous lesions of the head and neck. Granulomatous lesions are seen in different regions of the head and neck and a difficult diagnostic challenge for the radiologist. Infective granulomas may be due to bacterial or fungal agents. Non-infective granulomas are Wegener's granulomatosis, sarcoidosis, amyloidosis, chemical granuloma and reparative giant cell granuloma. Familiarity with the clinical presentation and imaging features of these lesions can suggest diagnosis in some cases. CT and MR imaging demonstrate the exact location, extension and effect on surrounding structures. A thorough knowledge of age, gender, common location, clinical features and imaging appearance of granulomatous lesions are important for diagnosis.
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Grenier PA, Beigelman-Aubry C, Brillet PY. Nonneoplastic Tracheal and Bronchial Stenoses. Radiol Clin North Am 2009; 47:243-60. [DOI: 10.1016/j.rcl.2008.11.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Herrak L, Maslout A, Benosmane A. [Tracheal scleroma and rhinoscleroma: a case report]. REVUE DE PNEUMOLOGIE CLINIQUE 2007; 63:115-8. [PMID: 17607218 DOI: 10.1016/s0761-8417(07)90112-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Scleroma is a specific granlomatous disease caused by an enterobacteria of the Klebsiella family (Klebsiella rhinoscleromatis), localized electively in the upper airways, particularly the nasal fossae, leading to the term "rhinoscleroma". Tracheal involvement is exceptional. The disease progresses slowly, leaving mutilating and stenosing scar tissue. Medical treatment using antibiotics and corticosteroids is the basic approach although surgical treatment may be needed for fibrosclerosis unresponsive to medical treatment. We report a case of rhinoscleroma which extended to the trachea. In light of this case, we examine the demographic, diagnostic, therapeutic and evolutive aspects of this disease.
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Affiliation(s)
- L Herrak
- Service de Chirurgie Thoracique, CHU Ibn-Sina, Rabat, Maroc.
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Maguiña C, Cortez-Escalante J, Osores-Plenge F, Centeno J, Guerra H, Montoya M, Cok J, Castro C. Rhinoscleroma: eight Peruvian cases. Rev Inst Med Trop Sao Paulo 2006; 48:295-9. [PMID: 17086321 DOI: 10.1590/s0036-46652006000500011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2005] [Accepted: 04/27/2006] [Indexed: 11/21/2022] Open
Abstract
Rhinoscleroma is a rare infection in developed countries; although, it is reported with some frequency in poorer regions such as Central Africa, Central and South America, Eastern and Central Europe, Middle East, India and Indonesia. Nowadays, rhinoscleroma may be erroneously diagnosed as mucocutaneos leishmaniasis, leprosy, paracoccidioidomycosis, rhinosporidiasis, late syphilis, neoplasic diseases or other upper airway diseases. From 1996 to 2003, we diagnosed rhinoscleroma in eight patients attended in the Dermatologic and Transmitted Diseases service of "Cayetano Heredia" National Hospital, in Lima, Peru. The patients presented airway structural alterations producing nasopharyngeal, oropharyngeal and, in one patient, laryngeal stenosis. Biopsy samples revealed large vacuolated macrophages (Mikulicz cells) in all patients. Ciprofloxacin 500 mg bid for four to 12 weeks was used in seven patients and oxytetracycline 500 mg qid for six weeks in one patient. After follow-up for six to 12 months the patients did not show active infection or relapse, however, all of them presented some degree of upper airway stenosis. These cases are reported because of the difficulty diagnosing the disease and the success of antibiotic treatment.
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Affiliation(s)
- Ciro Maguiña
- Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru.
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De Champs C, Vellin JF, Diancourt L, Brisse S, Kemeny JL, Gilain L, Mom T. Laryngeal scleroma associated with Klebsiella pneumoniae subsp. ozaenae. J Clin Microbiol 2005; 43:5811-3. [PMID: 16272528 PMCID: PMC1287788 DOI: 10.1128/jcm.43.11.5811-5813.2005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Klebsiella pneumoniae subsp. ozaenae was isolated from the pharynx of a woman with laryngeal scleroma. K. pneumoniae subsp. ozaenae is rarely isolated from clinical infections and has never been reported in laryngeal scleroma, which is usually caused by K. pneumoniae subsp. rhinoscleromatis.
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Affiliation(s)
- C De Champs
- Service de Bactériologie-Virologie-Hygiène, CHU Robert Debré Rue du Général Koenig, 51092 Reims Cedex, France.
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Abstract
Chronic rhinosinusitis often fails to respond to standard medical or surgical treatment. In some of these cases, the underlying disease may be a chronic granulomatous process that requires aggressive topical, local, and in some instances, systemic therapy. Diseases that can present in this manner include autoimmune vasculitis, sarcoidosis, indolent infections, neoplastic processes, and various other miscellaneous conditions. This article reviews the typical presentations for some of these unusual conditions and discusses the appropriate evaluations that will lead to clinical identification and effective medical management.
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Affiliation(s)
- Thomas A Tami
- University of Cincinnati College of Medicine, 231 Albert Sabin Way, P.O. Box 670528, Cincinnati, OH 45267, USA.
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Prince JS, Duhamel DR, Levin DL, Harrell JH, Friedman PJ. Nonneoplastic lesions of the tracheobronchial wall: radiologic findings with bronchoscopic correlation. Radiographics 2002; 22 Spec No:S215-30. [PMID: 12376612 DOI: 10.1148/radiographics.22.suppl_1.g02oc02s215] [Citation(s) in RCA: 177] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Nonneoplastic diseases of the central airways are uncommon but can be categorized as either focal or diffuse, although there is some overlap. Focal diseases include postintubation stenosis, postinfectious stenosis, posttransplantation stenosis, and various systemic diseases that may involve the airways and lead to focal stenosis (eg, Crohn disease, sarcoidosis, Behçet syndrome). Diffuse diseases of the central airways include Wegener granulomatosis, relapsing polychondritis, tracheobronchopathia osteochondroplastica, amyloidosis, papillomatosis, and rhinoscleroma. Conventional radiography is often the first step in the evaluation of suspected central airway disease and may be adequate in itself to identify the abnormality. However, computed tomography (CT) improves both the detection and characterization of central airway disease. Bronchoscopy remains the primary procedure for the diagnostic work-up of these disease entities. Nevertheless, a thorough radiologic evaluation with radiography and CT may demonstrate specific imaging findings (eg, calcification) that can help narrow the differential diagnosis and aid in the planning of bronchoscopy or therapeutic intervention.
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Affiliation(s)
- Jeffrey S Prince
- Department of Radiology, Division of Pulmonary and Critical Care Medicine, UCSD Medical Center, 200 W Arbor Dr, Mail Code 8756, San Diego, CA 92103-8756, USA
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Abstract
Rhinoscleroma is increasing in incidence in the United States. It should be considered in patients who are immigrants from endemic countries and present with nasal polyposis that exhibits significant adherence to the nasal septum and relative sparing of the sinuses. Fluoroquinolones are emerging as the adjunctive antibiotic treatment of choice to complement surgical extirpation of the disease.
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Affiliation(s)
- M E Ammar
- Department of Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark 07103, USA
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Omeroglu A, Weisenberg E, Baim HM, Rhone DP. Pathologic quiz case. Supraglottic granulomas in a young Central American Man. Arch Pathol Lab Med 2001; 125:157-8. [PMID: 11151073 DOI: 10.5858/2001-125-0158-pqcsgi] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A Omeroglu
- Department of Pathology, illinois Masonic Medical Center, Chicago, USA
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Boggino HE, Borkowski J, Xiao SY. Pathologic quiz case. Polypoid intranasal mass in 32-year-old woman. Arch Pathol Lab Med 2001; 125:159-60. [PMID: 11151074 DOI: 10.5858/2001-125-0159-pqcpim] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- H E Boggino
- Department of Pathology, University of Texas Medical Branch at Galveston, USA
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Yigla M, Ben-Izhak O, Oren I, Hashman N, Lejbkowicz F. Laryngotracheobronchial involvement in a patient with nonendemic rhinoscleroma. Chest 2000; 117:1795-8. [PMID: 10858419 DOI: 10.1378/chest.117.6.1795] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
We report the first case of rhinoscleroma in an Israeli citizen, a former sailor with a transatlantic shipping company. Characteristic histologic changes from a tracheal biopsy and isolation of Klebsiella rhinoscleromatis from a blood culture after diagnostic bronchoscopy confirmed the diagnosis. Extreme delay in the diagnosis, a not uncommon feature in nonendemic areas, was associated with severe advanced laryngotracheobronchial disease. Treatment with quinolones was followed by significant improvement, but the patient died 1 month after presentation, apparently from upper airway obstruction.
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Affiliation(s)
- M Yigla
- Division of Pulmonary Medicine, Rambam Medical Cente, Haifa, Israel.
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Abou El-Hamd KA. Scleroma of the larynx and associated squamous cell carcinoma: a causal relationship? Ann Otol Rhinol Laryngol 2000; 109:306-10. [PMID: 10737316 DOI: 10.1177/000348940010900313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The known risk factors for development of laryngeal carcinoma are smoking, alcohol drinking, air pollution, laryngeal keratosis, single adult papillomas, and previous irradiation. Laryngeal scleroma as a risk factor for the development of laryngeal carcinoma has not been mentioned in the English-language literature, to my knowledge. This is a report of 2 cases of proven long-term rhinolaryngoscleroma that have changed to laryngeal carcinoma.
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Affiliation(s)
- K A Abou El-Hamd
- Department of Otolaryngology, Sohag Medical School, South Valley University, Egypt
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Braun-Falco O, Plewig G, Wolff HH, Burgdorf WHC. Bacterial Diseases. Dermatology 2000. [DOI: 10.1007/978-3-642-97931-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Manohar MB, Saleem M, McArthur P, Tulbah A. Laryngeal inflammation mimicking laryngeal carcinoma. J Laryngol Otol 1997; 111:568-70. [PMID: 9231095 DOI: 10.1017/s0022215100137934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A case of severe inflammation with an exuberant granulation lesion of the larynx that mimicked laryngeal tumour is presented. A patient who was a chronic smoker, with a history of hoarse voice underwent multiple endoscopies and biopsies, confirmed histopathologically as acute and, subsequently, as chronic inflammation. The tumour-like tissue in the larynx responded dramatically to prolonged antibiotic treatment. We emphasize the importance of histological confirmation before embarking on removal of an essential organ or part of the body which could lead to physical or emotional scarring.
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Affiliation(s)
- M B Manohar
- Otolaryngology-Head and Neck Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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