Rhinoscleroma is a progressive, chronic condition affecting the nasal passages and airways. A bacterial infection causes it.

The infection causes lumps, called granulomas, to develop. As these granulomas get larger, they can cause scarring and damage.

Although these lesions usually occur in the nasal cavity, they can also develop in the mouth, throat, and on the lips.

Rhinoscleroma is a rare condition in North America, but the bacteria that cause it can be found in many parts of the world. It is more common in parts of Africa, Eastern Europe, South America, and Southeast Asia.

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Rhinoscleroma is an inflammatory condition that causes lesions in the nose and other parts of the respiratory system. It is caused by the Klebsiella rhinoscleromatis bacteria.

The condition causes inflammation and tissue damage. As it progresses, lesions called granulomas develop.

It is estimated that 95% of cases of rhinoscleroma occur in the nasal cavity. Lesions may also develop in the bronchi, larynx, trachea, lips, mouth, and sinuses.

Rhinoscleroma is rare in North America and Western Europe. It is considered endemic in parts of Africa, Eastern Europe, South America, and Southeast Asia.

Rhinoscleroma is a chronic condition. This means that over time, symptoms typically get worse.

In the early stages, a person may experience recurring sinus infections, a cough, a runny nose, and general nasal irritation. As the lesions grow, a person may start to experience nose bleeds or a change in the structure of the nasal passages.

The symptoms of early-stage rhinoscleroma are similar to those of many other conditions. Therefore, it can easily go undiagnosed.

To confirm a diagnosis, a doctor will take a sample of the granuloma tissue. They will analyze the sample for cells called Mikulicz cells. These are large cells containing the bacteria, and they are named after the man who identified them.

In the first stage of rhinoscleroma, the number of these cells may not be present in a biopsy sample. However, in the second stage, there are many Mikulicz cells in the lesions.

Along with a test for Mikulicz cells, doctors may try to isolate Klebsiella rhinoscleromatis bacteria.

There are three stages of rhinoscleroma: catarrhal, proliferative, and cicatricial.

  • Catarrhal: Also called exudative, this is the earliest stage. It is associated with mild symptoms like nasal congestion, sneezing, runny nose, and cough. These symptoms can worsen over time and cause nose bleeds, crusting, and discharge with an unpleasant odor.
  • Proliferative: Also called granulomatous, in this stage, masses called granulomas start to grow. They can become inflamed and block nasal passages.
  • Cicatricial: Also called scleromatous, more granulomas develop, and they further block the airways and nasal passages. This can cause the shape of the nose and airways to change and may result in permanent changes in bone structure and significant scarring. It may be referred to as a Hebra nose.

Since a bacterial infection causes rhinoscleroma, it can be treated with antibiotics. Some antibiotics used to treat rhinoscleroma are rifampicin, fluoroquinolone, and ciprofloxacin.

To fully treat rhinoscleroma, a person may need to take antibiotics for up to six months. Treatment time can vary from several weeks to several months, and it is guided by when cultures and biopsies turn negative.

Depending on how long a person has had rhinoscleroma and what stage they were at, they may need surgery. However, this is rare. It may be necessary if there have been structural changes because of the granulomas. This will only occur once the bacteria has cleared.

Rhinosporidiosis is another inflammatory condition that affects the nasal and respiratory passages. It has very similar symptoms to those of rhinoscleroma.

Rhinosporidiosis is caused by a pathogen called Rhinosporidium seeberi. This is a parasite that lives in bodies of water and is most common in India and Sri Lanka.

This infection mainly affects the nasal cavity, but it affects the eyes in 10–18% of cases. It causes small, inflamed growths that bleed easily.

Since rhinosporidiosis is not caused by bacteria, antibiotics are not used to treat this condition. The polyps caused by rhinosporidiosis are usually surgically removed by a doctor.

The symptoms in the early stage of rhinoscleroma are similar to many other conditions. Symptoms such as sinus congestion and a runny nose can be caused by many things, so a person may attribute them to allergies or the common cold.

If a person continues to experience symptoms and they are getting worse, it is a good idea to contact a doctor.

Rhinoscleroma is not common in North America, but the bacteria that causes it is found in many other parts of the world. If a person has ongoing nasal symptoms and has traveled to a country where it is prevalent, they should seek medical attention.

Rhinoscleroma is an inflammatory condition that typically develops in the nasal and respiratory passages. It is caused by the Klebsiella rhinoscleromatis bacteria.

As it progresses, it creates inflammation and lesions in the nasal cavity and other areas. These granulomas can cause changes in the structure of the nose and airways.

Treatment is typically a long course of antibiotics along with surgery to help repair the areas affected by rhinoscleroma.