Bigi A, Bartolomeo M, Costes V, Makeieff M
Département de chirurgie cervico-faciale, centre hospitalo universitaire, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
Département de chirurgie cervico-faciale, centre hospitalo universitaire, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2016 Feb;133(1):51-3. doi: 10.1016/j.anorl.2015.03.009. Epub 2016 Jan 4.
Tracheal rhinoscleroma is an infectious granulomatosis of the tracheobronchial tract caused by a Gram-negative bacillus. Exclusively tracheal involvement has been rarely reported in the literature. The purpose of this study was to report a case of subglottic stenosis secondary to rhinoscleroma.
A 46-year-old North African woman with no medical or surgical history presented with inspiratory dyspnoea that had been present for several years. Endoscopic examination under general anaesthesia revealed tracheal stenosis. Histological examination of mucosal biopsies demonstrated Mikulicz cells and culture of bacteriological samples taken during a second biopsy confirmed the diagnosis of rhinoscleroma. CO2 laser subglottic obstruction relief was performed and treatment with ofloxacin was initiated. No recurrence of tracheal stenosis was observed with a follow-up of 6 months.
The diagnosis of rhinoscleroma is based on histological and bacteriological examination. Cultures are positive in 60% of cases, but negative cultures do not exclude the diagnosis of rhinoscleroma. Specific treatment consists of long-term antibiotic therapy, while surgery may be indicated for symptomatic treatment.
气管硬结症是一种由革兰氏阴性杆菌引起的气管支气管感染性肉芽肿病。文献中很少报道仅累及气管的情况。本研究的目的是报告一例继发于硬结症的声门下狭窄病例。
一名46岁无内科或外科病史的北非女性，出现吸气性呼吸困难数年。全身麻醉下的内镜检查显示气管狭窄。黏膜活检的组织学检查发现了米库利奇细胞，第二次活检时采集的细菌学样本培养证实了硬结症的诊断。实施了二氧化碳激光声门下梗阻解除术，并开始使用氧氟沙星治疗。随访6个月未观察到气管狭窄复发。
硬结症的诊断基于组织学和细菌学检查。60%的病例培养呈阳性，但培养阴性不能排除硬结症的诊断。特异性治疗包括长期抗生素治疗，而手术可用于对症治疗。
