Klebsiella pneumoniae subspecies rhinoscleromatis: Difference between revisions

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Background

Causative organism of rhinoscleroma, a chronic granulomatous disease of nasal and respiratory tract
Also known as respiratory scleroma

Microbiology

Subspecies of Gram-negative bacillus within the species Klebsiella pneumoniae

Epidemiology

Not found outside of human hosts
Primarily found in developing countries worldwide, in particular Mexico, Central America, and the Middle East
Transmitted by close contact

Clinical Manifestations

Non-specific early symptoms make it a challenging diagnosis
Causes chronic inflammation of the nasal pathways and other parts of respiratory tract
Starts with atrophic stage followed by granulomatous stage and finally fibrotic stage
By the time it is diagnosed, it is often already quite disfiguring, with airway compromise
Presents with nodules or masses in the nasal passages or other parts of the naso- or oropharynx or respiratory tract
Can occasionally erode through bone to cause CNS infections

Differential Diagnosis

Tuberculosis
Leprosy
Fungal infections
Granolumatosis with polyangiitis
Malignancy, including less commonly T cell lymphoma and basal cell carcinoma
Sarcoidosis

Diagnosis

Biopsy shows granulomatous inflammation with foamy macrophages (known as Mikulicz cells), which contain intracellular bacteria
Grow in routine culture

Manageemnt

Treated with 6 to 8 weeks of antibiotics (or longer), with or without surgical debridement, but high relapse rate
Traditionally treated with streptomycin or tetracycline; more recently, may be treated with co-trimoxazole or [[[fluoroquinolones]]

@@ Line 1: / Line 1: @@
-* A chronic granulomatous disease of nasal and respiratory tract caused by ''[[Is caused by::Klebsiella pneumoniae]]'' subspecies ''rhinoscleromatis''
+{{DISPLAYTITLE:''Klebsiella pneumoniae'' subspecies ''rhinoscleromatis''}}
-* Primarily found in developing countries worldwide
+== Background ==
+* Causative organism of '''rhinoscleroma''', a chronic granulomatous disease of nasal and respiratory tract
+* Also known as '''respiratory scleroma'''
+=== Microbiology ===
+* Subspecies of [[Stain::Gram-negative]] [[Shape::bacillus]] within the species [[Species::Klebsiella pneumoniae]]
+=== Epidemiology ===
+* Not found outside of human hosts
+* Primarily found in developing countries worldwide, in particular Mexico, Central America, and the Middle East
 * Transmitted by close contact
+== Clinical Manifestations ==
+* Non-specific early symptoms make it a challenging diagnosis
+* Causes chronic inflammation of the nasal pathways and other parts of respiratory tract
+* Starts with atrophic stage followed by granulomatous stage and finally fibrotic stage
+* By the time it is diagnosed, it is often already quite disfiguring, with airway compromise
 * Presents with nodules or masses in the nasal passages or other parts of the naso- or oropharynx or respiratory tract
+* Can occasionally erode through bone to cause CNS infections
-* Biopsy shows granulomatous inflammation with foamy macrophages
-* Treated with 6 to 8 weeks of antibiotics, but high relapse rate
+== Differential Diagnosis ==
+* [[Tuberculosis]]
+* [[Leprosy]]
+* Fungal infections
+* [[Granolumatosis with polyangiitis]]
+* Malignancy, including less commonly [[T cell lymphoma]] and [[basal cell carcinoma]]
+* [[Sarcoidosis]]
+== Diagnosis ==
+* Biopsy shows granulomatous inflammation with foamy macrophages (known as Mikulicz cells), which contain intracellular bacteria
+* Grow in routine culture
+== Manageemnt ==
+* Treated with 6 to 8 weeks of antibiotics (or longer), with or without surgical debridement, but high relapse rate
+* Traditionally treated with [[streptomycin]] or [[tetracycline]]; more recently, may be treated with [[co-trimoxazole]] or [[[fluoroquinolones]]
 [[Category:Head and neck infections]]