Rhinoscleroma: eight Peruvian cases Rinoscleroma: oito casos peruanos

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Ciro Maguiña, Juan Cortez-Escalante, Fernando Osores-Plenge, Jorge Centeno, Humberto Guerra, Manuel Montoya, Jaime Cok, Cleudson Castro
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2006
• Subjects: Rhinoscleroma; Scleroma; Klebsiella rhinoscleromatis; Chronic granulomatous infection; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/S0036-46652006000500011; https://doaj.org/article/c249c6ce3ddb493692e8ec345774d18e

Rhinoscleroma is a rare infection in developed countries; although, it is reported with some frequency in poorer regions such as Central Africa, Central and South America, Eastern and Central Europe, Middle East, India and Indonesia. Nowadays, rhinoscleroma may be erroneously diagnosed as mucocutaneos leishmaniasis, leprosy, paracoccidioidomycosis, rhinosporidiasis, late syphilis, neoplasic diseases or other upper airway diseases. From 1996 to 2003, we diagnosed rhinoscleroma in eight patients attended in the Dermatologic and Transmitted Diseases service of "Cayetano Heredia" National Hospital, in Lima, Peru. The patients presented airway structural alterations producing nasopharyngeal, oropharyngeal and, in one patient, laryngeal stenosis. Biopsy samples revealed large vacuolated macrophages (Mikulicz cells) in all patients. Ciprofloxacin 500 mg bid for four to 12 weeks was used in seven patients and oxytetracycline 500 mg qid for six weeks in one patient. After follow-up for six to 12 months the patients did not show active infection or relapse, however, all of them presented some degree of upper airway stenosis. These cases are reported because of the difficulty diagnosing the disease and the success of antibiotic treatment. O rinoscleroma é uma infecção rara nos países desenvolvidos, no entanto, tem sido relatado com alguma freqüência nas regiões pobres da África Central, América Central e do Sul, Europa Central e Oriental, Oriente Médio, Índia e Indonésia. A doença pode ser erroneamente diagnosticada como leishmaniose mucocutânea, hanseníase, paracoccidioidomicose, rinosporidiose, sífilis tardia, neoplasias ou outras doenças que afetam a via respiratória superior. No período de 1996 a 2003, foram diagnosticados oito casos de rinoscleroma no serviço de Doenças Dermatológicas e Infecciosas do Hospital Nacional "Cayetano Heredia", em Lima, Peru. Os pacientes apresentaram alterações estruturais das vias respiratórias, caracterizadas por estenose da nasofaringe e orofaringe, e em um paciente, a nível da laringe. ...