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Canadian Respiratory Journal
Volume 12, Issue 1, Pages 43-45
http://dx.doi.org/10.1155/2005/501457
Case Report

Rhinoscleroma Causing Upper Airway Obstruction

Geetika Verma,1 D Kanawaty,1 and R Hyland1

1University of Toronto, Department of Medicine, Canada
2North York General Hospital, Division of Respirology, Department of Medicine, Canada
3St Michael’s Hospital, Division of Respirology, Department of Medicine, Toronto, Ontario, Canada

Copyright © 2005 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rhinoscleroma is a chronic granulomatous condition of the respiratory tract, and is not uncommon in tropical regions; particularly, Mexico, Central America and the Middle East. A few cases have been reported in North America, primarily involving immigrants from endemic countries. The causative organism is Klebsiella rhinoscleromatis, a Gram-negative coccobacillus. Diagnosis is made on the basis of culture of the organism and the characteristic pathology of Mikulicz cells on light microscopy. The condition primarily affects the upper airway, and frequently presents with nasal discharge, nasal obstruction or frontal facial pain. Despite the term 'rhinoscleroma', there may be involvement of the entire respiratory tract. Although the condition is slowly progressive, its natural course portends extensive destruction. Laryngotracheal involvement occurs in approximately 15% to 80% of cases, but patients rarely present with isolated laryngotracheal disease. In the present paper, a case of rhinoscleroma presenting with symptoms of upper airway obstruction is described.