Summary
The diagnosis of rhinoscleroma was confirmed in a 17-year-old female patient from Tehran, Iran, suffering from a roundish tumour of the nose. Prior treatment with streptomycin and tetracycline had been unsuccessful. A three-month course of high-dose oral ciprofloxacin (750 mg b. i. d.) led to prompt cessation of the growth of the granuloma which was removed later by plastic surgery. Although serology alone appeared to have little value for the specific diagnosis of rhinoscleroma, a significant increase of IgG antibodies during treatment with ciprofloxacin confirmed infection byKlebsiella rhinoscleromatis in this case.
Zusammenfassung
Bei einer 17jährigen Patientin aus Teheran/Iran, die sich wegen einer tumorösen Raumforderung der Nase vorstellte, wurde histologisch die Diagnose eines Rhinoskleroms gesichert. Da vorangegangene Behandlungen mit Streptomycin und Tetrazyklinen erfolglos geblieben waren, wurde ein Therapieversuch mit hochdosiertem Ciprofloxacin (2 × 750 mg/d p. o.) unternommen. Unter der Therapie kam es zu einem raschen Wachstumsstillstand des Granuloms, das später chirurgisch entfernt wurde. Serologische Untersuchungen zeigten einen signifikanten Anstieg von IgG-Antikörpern gegenKlebsiella rhinoscleromatis unter der Therapie. Die Patientin ist seit mehr als drei Jahren symptomlos.
Similar content being viewed by others
References
DiBartolomeo, J. R. Scleroma of the nose and pharynx. West. J. Med. 124 (1976) 13–17.
Goldberg, S. N., Canalis, R. F. Rhinoscleroma as a cause of airway obstruction. Ear Nose Throat J. 59 (1980) 145–149.
Wahi, A. L., Misra, R. N. A note on the geographical distribution of scleroma. J. Laryngol. Otol. 78 (1964) 573–576.
Hoffmann, E. O., Loose, L. D., Harkin, J. C. The Mikulicz cell in rhinoscleroma: light, fluorescent, and electron microscopic studies. Am. J. Pathol. 73 (1973) 47–58.
Meyer, P. R., Shum, T. K., Becker, T. S., Taylor, C. R. Scleroma (rhinoscleroma). A histologic immunohistochemical study with bacteriological correlates. Arch. Pathol. Lab. Med. 107 (1983) 377–383.
Toppozada, H., Mazloum, H., El-Sawy, M., Malaty, R., Yakout, Y. The complement fixation test in rhinoscleroma. J. Laryngol. Otol. 97 (1983) 55–57.
Shum, T. K., Whitaker, C. W., Meyer, P. R. Clinical update on rhinoscleroma. Laryngoscope 92 (1982) 1149–1155.
Rissing, J. P., Buxton, T. B., Moore, W. L. III, Ozawa, T., Moore, W. L. Jr. Enzyme-linked immunospecific antibody test for detecting antibody toKlebsiella. J. Clin. Microbiol. 8 (1978) 704–707.
Granström, M., Wretlind, B., Markman, B., Cryz, S. J. Enzyme-linked immunosorbent assay to evaluate the immunogenicity of a polyvalentKlebsiella capsular polysaccharide vaccine in humans. J. Clin. Microbiol. 26 (1988) 2257–2261.
Quevedo, J. Scleroma in Guatemala, with a study of the disease based on the experience of 108 cases. Ann. Otol. Rhinol. Laryngol. 58 (1949) 613–645.
Cone, L. A., Barton, S. M., Woodard, D. R. Treatment of scleroma with ceforanide. Arch. Otolaryngol. Head Neck Surg. 113 (1987) 374–376.
Wise, R., Andrews, J. R., Edwards, L. J. In vitro activity of Bay 09867, a new quinolone derivative, compared with those of other antimicrobial agents. Antimicrob. Agents Chemother. 23 (1983) 559–564.
Easmon, C. S. F., Crane, J. P. Uptake of ciprofloxacin by human neutrophils. J. Antimicrob. Chemother. 16 (1985) 67–73.
Easmon, C. S. F., Crane, J. P. Uptake of ciprofloxacin by macrophages. J. Clin. Pathol. 38 (1985) 442–444.
Montgomerie, J. Z. Epidemiology ofKlebsiella and hospital-associated infections. Rev. Infect. Dis. 1 (1979) 736–753.
Ørskow, I., Ørskov, F. Serotyping ofKlebsiella. In:Bergan, T. (ed.): Methods in Microbiology, vol. 14. Academic Press, London, Orlando, San Diego (1984) pp. 143–164.
Slopek, S. Klebsiella. In:Sedlak, J., Rische, H. (eds.): Enterobacteriaceae-Infektionen. Leipzig: Georg Thieme Verlag (1968) pp. 531–557.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Trautmann, M., Held, T., Ruhnke, M. et al. A case of rhinoscleroma cured with ciprofloxacin. Infection 21, 403–406 (1993). https://doi.org/10.1007/BF01728925
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01728925