Rhinoscleroma: report of 2 cases and literature review

Abstract

Background: Rhinoscleroma is a chronic and specific granulomatous infectious disease caused by enterobacteria of the family Klebsiella: "Klebsiella rhinoscleromatis"; it reaches the nasal cavities in 95% of cases. The objective of our study is to report the clinical, diagnostic and therapeutic aspects of our patients. Observations/Medical findings: The study took place at the ENT department of the Fann National University Hospital Center in Dakar, and it was based on two female subjects who are 26 and 60 years old, respectively. The medical examination of the subjects indicated a granulomatous lesion blocking the two nasal cavities. A biopsy performed on each patient revealed a rhinoscleroma. Both patients received doxycycline-based medical treatment with endoscopic endonasal surgery like "Debulking." The patients all recovered nasal breathing after airway clearance. However, we noted a scar retraction of the nasal cavities in the first patient. Conclusions: As the disease recurs, rhinoscleroma is becoming more and more a cosmopolitan affection. The diagnosis is histological. Well-conducted medical treatment allows healing in early forms while surgery is complementary in advanced forms. The fear of a recurrence calls for an extended follow-up.