Extensiv scleroma at 11 years old girl

Abstract

Rhinoscleroma is a rare chronic granulomatous disease caused by Klebsiella rhinoscleromatis, which is a Gram-negative bacilli. Scleroma primarily affects the upper respiratory airway, preferably the nasal cavity, but the pharynx and larynx may also be involved. The term scleroma is preferred over the term rhinoscleroma because this disease affects not only the nose. Scleroma is endemic in countries of East Europe, Africa, South-East Asia and in sporadic areas worldwide. Scleroma usually begins at the nose and may progress to involve the larynx, pharynx or other regions of the neck. Scleroma generally progresses in three stages: the catarrhal or exudative phase, the proliferative or granulomatous phase, the sclerotic stage. Diagnosis of Rhinoscleroma depends on identification of the pathognomonic Mickulicz cells which is most prominent during granulomatous phase but spares or absent during catarrhal or sclerotic phases of the disease. We report a case of 11-year-old girl with the sclerotic stage of scleroma. This diagnose was proved by Mikulich cells histological detecting. We review the history, epidemiology, pathology, diagnosis, and treatment of scleroma. We report the case of a 11-year-old girl, hospitalize in our institute, diagnosed with rhinoscleroma in the context of recurrent breathlessness, wheezes and cough. The diagnosis difficulty caused by changes of nasal laryngeal mucous membrane after septoplasty 3 months ago and bronchial asthma diagnosed 2 years ago. The patient was given a six-month regimen of ciprofloxacin, and a dramatic improvement was observed.