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ENT General fe7f3b36

All are true about Rhinoscleroma, except ?

A
Mikulicz cells
B
Caused by fungus
C
More common in Nohern area
D
Woody nose
High-Yield Explanation
Ans. is 'b' i.e., Caused by fungus Rhinoscleroma is caused by a bacterium. Rhinoscleroma The causative organism is Klebsiella rhinoscleromatis or Frisch bacillus, which can be cultured from the biopsy material. The disease is endemic in several pas of world. In India, it is seen more often in nohern than in the southern pas. Biopsy shows infiltration of submucosa with plasma cells, lymphocytes, eosinophils, Mikulicz cells & Russell bodies. The latter two are diagnostic features of the disease. The disease stas in the nose & extends to nasopharynx, oropharynx, larynx, trachea & bronchi. Mode of infection is unknown. Both sexes of any age may be affected. Clinical features of rhinoscleroma The disease runs through the following stages :? a. Atrophic stage : It resembles atrophic rhinitis and is characterised by foul smelling purulent nasal discharge and crusting. b. Granulomatous stage : Granulomatous nodules form in nasal mucosa. There is also subdermal infiltration of lower pa of external nose and upper lip giving a 'woody' feel. Nodules are painless and non-ulcerative. c. Cicatricial stage : This causes stenosis of nares, distoion of upper lip, adhesions in the nose, nasopharynx and oropharynx. There may be subglottic stenosis with respiratory distress. Biopsy of rhinoscleroma shows infiltration of submucosa with plasma cells, lymphocytes, eosinophils, Mikulicz cells and Russell bodies. The latter two are the diagnostic features of the disease. Treatment Both streptomycin & tetracycline are given together for minimum of 4-6 wks. Steroid can be combined to reduce fibrosis. Surgical treatment may be required to establish the airway and correct nasal deformity

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