J Korean Med Sci.
2003 Jun;18(3):455-458. 10.3346/jkms.2003.18.3.455.
Nasal Rhinoscleroma in a Nonendemic Area: A Case Report
- Affiliations
-
- 1Department of Pathology, Kangnam General Hospital Public Corporation, Korea.
- 2Department of Otolaryngology, Kangnam General Hospital Public Corporation, Korea.
- 3Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jhhan@smc.samsung.co.kr
- KMID: 2157670
- DOI: http://doi.org/10.3346/jkms.2003.18.3.455
Abstract
- Rhinoscleroma is a chronic, granulomatous infectious lesion most frequently affecting the respiratory tract mucosa. This disease is endemic to Africa, Central and South America, South Central and Eastern Europe, the Middle East, and China. We report an extremely rare disease of nasal rhinoscleroma in Korea. The patient was a 63-yr-old man, who suffered from chronic nasal obstruction and septal deviation. Characteristic histology from a nasal biopsy was proven and special stains for bacteria were employed: periodic acid-Schiff, Warthin-Starry silver, Giemsa, and Gram stains. Isolation of Klebsiella rhinoscleromatis from a culture of nasal discharge was failed, but ultrastructural examination of numerous phagocyzed bacilli in the Mikulicz cells confirmed the diagnosis. The histiocytic nature of the Mikulicz cells was confirmed, using CD 68 and alpha-1 antitrypsin, and by the ultrastructural features of Mikulicz cells. Here, we emphasize the recognition of this rare entity in nonendemic regions, frequently leading to delayed diagnosis.
