Thursday, September 20, 2018

Question: Rhinoscleroma

#Medicowesome
#Ent

Which of the following feature(s) of rhinoscleroma is/are true except:-
1) Atrophy of nasal mucosa
2) Caused by fungus
3) Treatment by antifungal drug
4) Caused by bacteria
5) Causative organism may be cultured from biopsy material

Answer in 24 hours!

So correct options are option 2 and option 3.

Rhinoscleroma is bacterial chronic granulomatous infection caused by Klebsiella rhinoscleromatis or Frisch bacillus.

Mode of transmission
Not unknown


Pathology:
Starts in the nose and extend upto naso-pharynx, larynx, trachea and bronchi.

Clinical features:

1) Atrophic stage:
Foul-smelling prurulent nasal discharge and crusting.

2) Granulomatous stage:
"Woody nose" feel is seen in lower part of nose and upper lip. Nodules are painless and non-ulcerative.

3) Cicatrical stage:
Distortion of upper lip, adhesion in the nose, nasopharynx and stenosis of subglottis.

 Diagnosis:
 Presence of Mikulciz cells and Russell bodies 

1) Mikulicz cells: Macrophages containing central nuclues and vacuolated cytoplasm along with bacilli.

2) Russell bodies: Homogeneous eosinophilic inclusion bodies found in plasma cells.

Treatment:
Streptomycin and tetracycline given for 4-6 weeks and repeated.

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