RHINOSCLEROMA

Rhinoscleroma is a rare chronic  inflammatory condition caused by bacteria called Klebsiella rhinoscleromatis. Rhinoscleroma is characterised by granulomatous swellings (lumpy firm masses composed of immune cells) in the nose and other parts of the respiratory tract, such as the paranasal sinuses, mouth, lips, larynx, trachea, and bronchi. The disease is contracted by inhaling droplets or contaminated material and typically appears in patients aged 10-30 years of age.

RISK FACTORS

• immunodeficiency -HIV infection
• poverty
• poor hygiene
• prolonged contact with infected patients.

CLINICAL FEATURES

Three clinical stages have been described:

• Catarrhal stage – patients initially have non-specific symptoms, such as a runny nose or blocked nose. As the disease progresses, the nasal discharge may contain pus and develop a foul odour. Dry crusting of the mucous membranes of the nose can occur. This stage can last for weeks to months.
• Granulomatous -hypertrophic or proliferative stage – the mucosal tissue inside the nose becomes bluish-red, and rubbery nodules (lumps) form. As these granulomatous swellings grow, they can cause nasal enlargement and deformity. Symptoms include bleeding noses, nasal obstruction (or obstruction elsewhere in the respiratory tract), loss of the sense of smell, a hoarse voice, and thickening or numbing of the soft palate.
• Sclerotic or fibrotic phase – the granulation tissue is replaced by hardened scars, which can occasionally result in blocked airways.
• epistaxis, rhinorrhea, dysphagia, stridor, and dysphonia can also be seen.

DIAGNOSIS

1.Microscopic examination.

2.CT scan

3.MRI

HOMOEOPATHIC MANAGEMENT:

• CALCAREA FLOUR
• THUJA OCC
• AURUM MUR NAT
• PULSATILLA