Rhinoscleroma A Case Report with Review of Literature
Aim: Rhinoscleroma is a rare disease hence the diagnosis can be difficult and delayed because of its clinical polymorphism. This article aims to review the entity and depict one of the treatment modalities for the same. Background: Rhinoscleroma is a chronic granulomatous, slowly progressive disease affecting the nose and other respiratory tract structures, endemic in some areas of southern and central Europe, Africa and the USA. The first evidence of patients with scleroma was in a Mayan Indian terracotta head dated between 300 and 600 AD depicting the typical nasal proliferative lesions of this disease. Hebra and Kohn in 1870 first described the condition as 'rhinoscleroma' and considered it a neoplastic growth. Its inflammatory nature was first suggested by Gerber. We report herein one case of this disease in a patient living in Lucknow and include a review of the literature. Case Description: The clinical and pathological features of patients diagnosed with rhinoscleroma are presented. A 45 years old female patient with a chief complaint of dull localized pain which aggravated during meals and subsided after medication. The swelling had gradually increased in size on right side of the face. She also had a complaint of watery nasal discharge associated with common cold along with nasal obstruction and difficulty in breathing during lying down position. Post histopathological confirmation of our diagnosis, we performed debulking of the lesion intraorally and Ciprofloxacin 750 mg twice daily for 6 weeks along with the Augmentin 625mg thrice daily for 4 weeks and Metrogyl 400 mg thrice daily were given for 1 week, all from the day of debulking. Conclusion: A combination of debulking and antibiotic therapy apparently produced satisfactory results for our patient. A study comparing this method of treatment with other treatment methods, such as the use of pharmacotherapy alone in such patients, with a longer follow up would be of considerable interest. Clinical Significance: A combination of debulking and antibiotic therapy can be taken into consideration as surgery results in immediate symptomatic relief and decrease the microbial load thereby increasing the sensitivity of the pharmacological therapy.