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At least 19 recordsLinked to original sources
PubMed1983

Scleroma (Rhinoscleroma). A histologic immunohistochemical study with bacteriologic correlates.

Scleroma was diagnosed in nine of 30 Spanish-surnamed patients who had inflammatory lesions of the nose, pharynx, and larynx during the two-year period from Jan 1, 1978, through Dec 31, 1979. A total of 19 biopsy specimens were taken from these nine patients. In six of the 19 specimens, a histologic diagnosis of scleroma was not possible. Seventeen of the specimens with characteristic histologic findings stained with the peroxidase-antiperoxidase method for detection of Klebsiella capsular antigen III, although in 11 of these specimens, simultaneous cultures failed to reveal the characteristic Klebsiella rhinoscleromatis. These specimens showed the features of one of the three histopathologic forms of scleroma: ozena, granuloma, or scleroma. A range of tissue reactions was identified: histiocyte and plasma cell nodules, vasculitis, acute inflammation, pseudoepitheliomatous hyperplasia, ulceration, and submucosal keratin cyst. Comparison with histochemical bacterial stains revealed that the PAS and Hotchkiss-McManus stains gave unequivocal positive results less frequently than the immunoperoxidase method, and were less specific. Methenamine silver, Giemsa, Deiterle, Brown and Brenn, and Brown and Hopps were unreliable for the detection of the organism. The immunoperoxidase method can be appropriately used when the spectrum of histopathologic findings suggests a differential diagnosis of scleroma.

Histocytochemistry↗
PubMed2004

[Clinical characteristic and treatment of laryngeal scleroma].

OBJECTIVE: To study the clinical manifestation and treatment of the laryngeal scleroma METHODS: Forty-three patients with laryngeal scleroma, from May, 1981 to December, 2002, with pathological diagnosed were reviewed retrospectively. The clinical features and the treatment methods of these patients were analysed. RESULTS: All 43 cases had hoarseness and 19 of them manifested dyspnea. In the larynx, the main scleromatous lesions were classified as atrophic stage in 2 cases, as granulomatous in 35 cases and as scarring in 6 cases. The preponderance lesions were located in the glottis in 13 cases, in the subglottis in 1 case, in both supraglottis and glottis in 18 cases, in both glottis and subglottis in 8 cases, and in all the three regions of the larynx in 3 cases. Twenty-four patients were treated with antibiotics, seven patients with surgery and two patients with radiotherapy. Eighteen of 24 patients who were treated with antibiotics were cured, and two of the recurrent patients were cured with a further period of antibiotics therapy. Four of the 24 patients with second or third degree of laryngeal obstruction required prophylactic tracheostomy. One patient in granulomatous stage with the second degree of laryngeal obstruction was cured with the combination of surgery and antibiotics therapy. Six patients in the scarring stage with laryngeal stenosis were cured with reconstruction surgery. One patient treated with radiotherapy recurred in the fourth year after treatment, and one patient failed to antibiotics therapy cured with radiotherapy combined with antibiotics therapy. CONCLUSIONS: Scleroma may involve the larynx and cause dysphonia and laryngeal obstruction. Antibiotics therapy is effective in most cases with laryngeal scleroma, and the long-time follow-up after treatment were necessary. Laryngeal reconstructions were necessary for the patients with cicatrical laryngeal stenosis.

Adolescent↗
PubMed1977

Scleroma (rhinoscleroma) in a Nigerian maxillo-facial practice. Review and case reports.

Scleroma (rhinoscleroma), a chronic granulomatous disease of the upper respiratory tract, is endemic within a confined distribution of geographic foci. Sporadic cases and those arising in poorly defined foci may be unexpected and difficult to diagnose. Three cases from a maxillo-facial unit in northern Nigeria are described, of which two simulated intranasal neoplasms and the third had atypical clinical features. These cases form the first substantial description of scleroma in Nigeria, a country that is part of an indefinite focus of the disease. The epidemiology, clinical features, pathology and diagnosis of scleroma are reviewed.

Adult↗
PubMed1996

Respiratory scleroma: a clinicopathologic and ultrastructural study.

Respiratory scleroma (rhinoscleroma) is a chronic granulomatous infection produced by Klebsiella rhinoscleromatis, a gram-negative aerobic coccobacillus. This disease is endemic to Africa, Central and South America, South Central and Eastern Europe, the Middle East, and China. Sporadic cases have been reported in the United States, especially in persons who migrated from the aforementioned areas. The majority of cases affect the nose, but extension to the soft and hard palate, upper lip, and maxillary sinuses also is frequent. This study comprises 11 patients (6 females and 5 males) with respiratory scleroma identified over a 6-year period in Guatemala. Their ages ranged from 16 to 60 years. Light microscopy showed a dense plasmacytic infiltrate, Mikulicz histiocytes, and Russell bodies within the plasma cells. Ultrastructural study revealed Mikulicz histiocytes, cytoplasmic vacuoles containing bacilli, and so-called A and B granules. We favor the term respiratory scleroma for this lesion because it affects not only the nose but also the upper and lower respiratory tracts as well as the mouth.

Adolescent↗
PubMed1991

Scleroma of the upper respiratory passages: a CT study.

Scleroma is a chronic specific granulomatous disease endemic in Egypt. The nasal cavities were all affected in the 37 patients examined. The paranasal sinuses and nasopharynx were involved in 17 patients, while the larynx and upper trachea were affected in five patients, four of whom were females. Twenty-three patients were in the granulomatous stage; the rest of the patients were in the atrophic and fibrotic stages. The main nasal and nasopharyngeal CT findings were soft tissue masses of variable sizes. The lesions were characteristically homogenous, non-enhancing and had distinct edge definition; adjacent fascial planes were not invaded. The subglottic area was involved in laryngeal and tracheal scleroma. The lesions were mainly in the form of concentric irregular narrowing of the airway. In the trachea, crypt-like irregularities were diagnostic of scleroma. Intra-orbital, intra-cranial and infratemporal parapharyngeal scleromatous masses were detected in one patient.

Adolescent↗
PubMed1994

Scleroma of the lower respiratory tract: case report and review of literature.

The case of a 46-year-old man who presented with acute respiratory distress due to a tracheal mass is reported. The patient underwent endoscopic resection of the mass and the histopathology revealed scleroma. No other sites of involvement by scleroma were found. This case is reported because laryngotracheal involvement by scleroma as the only manifestation of this disease is extremely rare.

Humans↗
PubMed1983

Endoscopy of lower respiratory tract scleroma.

Eleven cases of scleroma with lower respiratory tract affection were examined by the flexible and rigid bronchoscopes. The patterns of laryngeal, tracheal and bronchial scleroma as seen through the flexible scope are presented. In the larynx, diffuse and localized forms are found. The trachea was affected by granular or atrophic lesions. Stenosis of the main bronchi was seen in two patients. The present-day treatment of lower respiratory tract scleroma is discussed.

Adolescent↗
PubMed1999

Laryngeal scleroma.

Respiratory scleroma is a chronic, progressive granulomatous disease of the respiratory tract. The causal organism is the Klebsiella rhinoscleromatis. The disease has three stages: the initial catarrhal stage, granulomatous stage, and sclerotic stage. The object of this report was to determine the clinical behaviour of the laryngeal scleroma. The study included 17 patients with this manifestation characterized by airway obstruction and dysphonia. The report revealed that respiratory scleroma affected the larynx in 40%, and the principal findings were glottic/subglottic stenosis.

Adult↗
PubMed1976

Scleroma of the nose and pharynx.

Scleroma of the respiratory tract was first recognized just over a century ago. The disease is endemic in a number of North African, Central American and Latin American countries. However, it has been only rarely seen in the United States. The progression of scleroma takes place through three stages. The first stage of rhinitis has an early catarrhal phase which progresses to one of atrophic rhinitis. The second stage is seen as a proliferative granulomatous growth which obliterates the nasal fossae. The third cicatricial stage is usually accompanied by pronounced scarring and retraction of the tissues involved. Because of the increased ease of international travel by both sea and air, more cases can be expected to occur in the United States. This paper is presented to alert physicians to suspect scleroma in any case of granulomatous disease of the respiratory tract.

Adolescent↗
PubMed1978

Experimental scleroma. A histopathological study.

Klebsilla rhinoscleromatis suspension was experimentally inoculated into the nose and maxillary sinus of eight adult healthy rabbits. Two normal litter-mates served as controls. The animals were killed at varying intervals up to five months following the inoculation. Histopathological examination of the upper and lower respiratory tracts revealed a consistent pulmonary peribronchial and perivascular granulomatous reaction with a Mikulic cell-like appearance. The reaction was present in all the inoculated rabbits and increased in severity as the survival period was prolonged. The significance of these findings in the aetiopathogenesis of scleroma and to scleroma in humans is discussed.

Animals↗
PubMed1992

Ethmoidal scleroma: endoscopic diagnosis and treatment.

Twenty patients with medically treated rhinoscleroma and residual ethmoidal manifestations were examined using CT scanning. Cases with positive radiological data of the ethmoids underwent diagnostic and therapeutic nasal endoscopy. It has been found that ethmoidal scleroma is not as rare a condition as was previously thought. The diagnostic and therapeutic value of nasal endoscopy in ethmoidal scleroma is discussed.

Endoscopy↗