Association of rhinoscleroma with rhinosporidiosis.

Rhinoscleroma caused by the bacillus Klebsiella rhinoscleromatis and rhinosporidiosis caused by the fungus Rhinosporidium seebri are rare, specific nasal infections, both of which have a certain geographical distribution. To the best of our knowledge no association between them has been reported in the international literature. We have documented such an association in two male Indian patients aged-32 and 27 years, respectively-both presenting with unilateral blood-stained discharge and nasal blockage. They showed strawberry-like polypoidal masses, and histological examination confirmed the diagnosis. Klebsiella rhinoscleromatis was cultured twice in the first case. The patients were treated with complete excision and a long course of septrin, for which Klebsiella rhinoscleromatis is sensitive. The purpose of this paper is to report the first association of these two granulomatous infections, to show the impact of immigration on the differential diagnosis, and to review the relevant literature.