Rhinoscleroma: a clinicopathological study from the Gulf region

Abalkhail A, Satti MB, Uthman MAE, Al Hilli F, Darwish A, Satir A
Correspondence: Dr Ali Abalkhail, wagi47@yahoo.com

ABSTRACT
Introduction Rhinoscleroma is a chronic progressive inflammatory disease of the upper respiratory tract. We report a clinicopathological series from the Gulf region.
Methods The clinical and pathological features of patients diagnosed with rhinoscleroma at three main hospitals in Saudi Arabia and Bahrain over a 20-year period are presented. Archived glass slides and paraffin blocks from these patients were retrieved from the pathology files for review. Special stains were performed whenever indicated. Biopsy material and clinical data from 25 patients formed the basis of this study.
Results Most of the patients were young females with a median age of 24 years. The nose was involved in all cases with frequent extension to other parts of the upper respiratory tract. The provisional clinical diagnoses included syphilis, midline granuloma and malignancy. The histological differential diagnoses included leprosy, malakoplakia and metastatic renal cell carcinoma.
Conclusion Rhinoscleroma is rare in Saudi Arabia and Bahrain. Awareness of possible clinical presentations and early diagnosis will significantly reduce the morbidity caused by this disease.

Keywords: Klebsiella rhinoscleromatis, nasal inflammatory disease, nose, respiratory tract infection, rhinoscleroma, upper respiratory tract
Singapore Med J 2007; 48(2): 148–151