Klebsiella Rhinoscleroma

Epidemiology

  • Endemic Regions
    • Asia
    • Middle East
    • Eastern Europe
    • Central and South America

Etiology

  • Klebsiella rhinoscleromatis
    • Member of Klebsiella Genus (see Klebsiella)
    • Lactose-Fermenting Gram-Negative Rod

Pathogenesis

  • Chronic Inflammatory and Fibrosing Condition of Upper (and Sometimes Lower) Airways: may extend to and destroy adjacent bones and cartilage

Pathologic Pattern

  • Loosely Organized Granulomas: with plasma cell, lymphocyte, and foamy macrophage infiltration

Diagnosis

  • PFT’s: abnormal flow-volume loop
  • Bronchoscopy
    • Subglottic or lower tracheal stenosis
    • Bronchial stenosis
  • CXR/Chest CT Pattern
    • Normal CXR (no evidence of parenchymal lesions): usually (except possibly for post-obstructive signs)
  • Nasal Mucosal Biopsy: short Gram-negative rod (difficult to find in tissue sections)

Clinical


Treatment

  • Antibiotic Therapy: required for months-years
  • Laser Bronchoscopy: may be required for some lesions

References

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