Fawaz Samia, Tiba Medhat, Salman Manal, Othman Hala
Department of Otorhinolaryngology, Ain Shams University, Cairo, Egypt.
Clin Respir J. 2011 Apr;5(2):112-21. doi: 10.1111/j.1752-699X.2010.00207.x.
Scleroma is a chronic specific granulomatous disease. It is considered endemic in Central America, Egypt, tropical Africa, India, and Indonesia. The most common complaint is nasal obstruction, other symptoms include; rhinorrhea, epistaxis, dysphagia, stridor, and dysphonia.
So our objective was to focus on the various clinical and radiological manifestations of scleroma in an endemic area, with some atypical symptoms and signs, and to alert physicians to suspect scleroma or its complications in any case of unexplained nasal lesion.
Our study included 88 cases who were admitted in our otorhinolaryngology department. They presented with various manifestations of Rhino-pharyngo-laryngo scleroma, out of these patients 16 cases showed atypical presentations. Our diagnosis was based on clinical and radiological examination, aided by bacteriological and pathological examination.
Patients with typical rhinoscleroma (72 patients) presented with various nasal and laryngo-tracheal symptoms. 16 patients (18%) presented complaining of various nasal symptoms and signs, which were not suspected to be rhinoscleroma, so our workup was directed to diagnose those patients, and their final diagnosis was reached to be rhinoscleroma, we sub classified those patients according to their presentation.
Rhinoscleroma can present clinically with atypical features, so in order to avoid misdiagnosis, it is important to keep in mind these atypical manifestations.
硬结病是一种慢性特异性肉芽肿性疾病。它被认为在中美洲、埃及、热带非洲、印度和印度尼西亚呈地方性流行。最常见的主诉是鼻塞,其他症状包括:鼻溢、鼻出血、吞咽困难、喘鸣和声音嘶哑。
因此,我们的目标是关注地方性流行地区硬结病的各种临床和放射学表现,包括一些非典型症状和体征,并提醒医生在任何不明原因的鼻部病变病例中怀疑硬结病或其并发症。
我们的研究包括88例在我们耳鼻喉科住院的患者。他们表现出鼻咽喉硬结病的各种表现,其中16例表现为非典型症状。我们的诊断基于临床和放射学检查,并辅以细菌学和病理学检查。
典型鼻硬结病患者(72例)表现出各种鼻和喉气管症状。16例患者(18%)主诉各种鼻部症状和体征,最初未被怀疑为鼻硬结病,因此我们对这些患者进行了检查以明确诊断,最终确诊为鼻硬结病,我们根据他们的表现对这些患者进行了分类。
鼻硬结病在临床上可能表现为非典型特征,因此为避免误诊,牢记这些非典型表现很重要。