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Wang X, Liu Y. Offense and Defense in Granulomatous Inflammation Disease. Front Cell Infect Microbiol 2022; 12:797749. [PMID: 35846773 PMCID: PMC9277142 DOI: 10.3389/fcimb.2022.797749] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Granulomatous inflammation (GI) diseases are a group of chronic inflammation disorders characterized by focal collections of multinucleated giant cells, epithelioid cells and macrophages, with or without necrosis. GI diseases are closely related to microbes, especially virulent intracellular bacterial infections are important factors in the progression of these diseases. They employ a range of strategies to survive the stresses imposed upon them and persist in host cells, becoming the initiator of the fighting. Microbe-host communication is essential to maintain functions of a healthy host, so defense capacity of hosts is another influence factor, which is thought to combine to determine the result of the fighting. With the development of gene research technology, many human genetic loci were identified to be involved in GI diseases susceptibility, providing more insights into and knowledge about GI diseases. The current review aims to provide an update on the most recent progress in the identification and characterization of bacteria in GI diseases in a variety of organ systems and clinical conditions, and examine the invasion and escape mechanisms of pathogens that have been demonstrated in previous studies, we also review the existing data on the predictive factors of the host, mainly on genetic findings. These strategies may improve our understanding of the mechanisms underlying GI diseases, and open new avenues for the study of the associated conditions in the future.
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Affiliation(s)
- Xinwen Wang
- Shaanxi Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology, Department of Oral Medicine, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Yuan Liu
- Shaanxi International Joint Research Center for Oral Diseases, State Key Laboratory of Military Stomatology, Department of Histology and Pathology, School of Stomatology, The Fourth Military Medical University, Xi'an, China
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2
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Popadyuk VI, Kirichenko IM, Rogov KA. [Widespread of Scleroma. A rare clinical case]. Vestn Otorinolaringol 2021; 86:93-98. [PMID: 33929160 DOI: 10.17116/otorino20218602193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Scleroma is a chronic infectious disease characterized by developing inflammation nye granulomas, mainly of the upper respiratory tract, with subsequent scarring. The reasons for the development of scleroma remain unclear, but it is generally accepted that the gram-negative coccal bacterium Klebsiella rhinoscleromatis (pas-Volkovich's loch - Frisch) is the causative agent of this disease. Endemic in the spread of scleroma is considered There are tropical and temperate zones such as Africa, Asia, Eastern Europe, South America and Central America. Features of development scleroma in the present case and the complexity of the diagnosis caused by atypical, the rapid development of the disease, the greater prevalence of the process (including the orbit), with the transition to the soft tissues of the cheek bone and upper jaw, which is not typical for scleroma. The process was primarily localized in the left maxillary sinus and mimicked sinusitis. The presence of radicular cysts and darkening of the left maxillary sinus on radiographs, taking into account the clinical picture of the disease, were interpreted incorrectly, which led to the establishment of an incorrect diagnosis and subsequent surgical interventions. More targeted and consistent examination of histo-the logical material obtained after three surgical interventions made it possible to identify the characteristic signs scleroma, establish the correct diagnosis and prescribe effective treatment. In our case, we applied Ciprofloxacin course for 3 months at a maximum daily dose of 2000 mg in combination with probiotics. During treatment, it was noted a significant improvement in the patient's well-being, facial pains became less intense, a decrease in the volume of ma tissues of the left cheek and improved nasal breathing.
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Affiliation(s)
- V I Popadyuk
- Peoples' Friendship University of Russian, Moscow, Russia
| | - I M Kirichenko
- Peoples' Friendship University of Russian, Moscow, Russia.,International Medical Center «ON-Clinics», Moscow, Russia
| | - K A Rogov
- Peoples' Friendship University of Russian, Moscow, Russia.,Federal State Budget Scientific Institution «Research Institute of Human Morphology», Moscow, Russia
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Mariz BALA, Sánchez-Romero C, Romañach MJ, de Almeida OP, Carlos R. Respiratory scleroma: A clinicopathologic study of 51 cases from Guatemala. Oral Dis 2020; 26:670-676. [PMID: 31869492 DOI: 10.1111/odi.13264] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/03/2019] [Accepted: 12/17/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To evaluate clinical and pathologically cases of respiratory scleroma diagnosed in a 30-year period in Guatemala. MATERIAL AND METHODS Fifty-one cases of respiratory scleroma diagnosed from 1988 to 2018 in a single pathology service in Guatemala were confirmed using Warthin-Starry staining. Immunohistochemical reactions against CD68, LCA, CD20, CD3, and CD138 were performed to illustrate the inflammatory infiltrate. Scanning electron microscopy (SEM) was performed to illustrate bacteria morphology. RESULTS All 51 cases affected patients from poor areas of Guatemala, particularly women (66.7%), with a mean age of 31 years (range 7-66 years). Nose was affected in most cases (96.1%). Other sites involved included pharynx, larynx, palate, maxillary sinuses, and upper lip. Depending on the stage, the disease manifested as ulcerations, nasal deformities, or laryngeal stenosis. Nasal obstruction, epistaxis, dysphonia, fetid discharge, and pain were the main symptoms. Mikulicz cells (CD68+) in a plasma cell-rich inflammatory background (CD138+, CD20+, CD3+/-) were the typical microscopic presentation. In SEM, each macrophagic vacuole contained few to dozens of Klebsiella rhinoscleromatis diplobacilli. Treatment consisted of long-term trimethoprim and sulfamethoxazole, with adequate control of disease. CONCLUSION Respiratory scleroma is a rare infectious disease affecting the upper respiratory tract, in poor regions of the world, including Guatemala.
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Affiliation(s)
- Bruno A L A Mariz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Celeste Sánchez-Romero
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Molecular Pathology Area, Faculty of Dentistry, Universidad de la República, Montevideo, Uruguay
| | - Mário J Romañach
- Department of Oral Diagnosis and Pathology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Oslei P de Almeida
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Román Carlos
- Centro Clínico de Cabeza y Cuello, Guatemala City, Guatemala
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Elwany S, Fattah HA, Mandour Z, Ismail AS, Abdelnabi M. A Myriad of Scleroma Presentations: The Usual and Unusual. Head Neck Pathol 2019; 14:588-592. [PMID: 31529285 PMCID: PMC7413941 DOI: 10.1007/s12105-019-01075-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/06/2019] [Indexed: 11/27/2022]
Abstract
To prospectively study a series of scleroma patients with a focus on socioeconomic status, clinical presentation, pathology, microbiology, and treatment. A total of 52 patients diagnosed with scleroma were included in the study. Demographic data of the patients were collected and clinical, radiographic, and histopathologic findings were analyzed. Biopsies from atypical patients were sent for electron microscopic examination. Patients were treated both medically and surgically with clinical follow-up to determine outcomes and the incidence of recurrence. Fifty-two patients were included in the study. There were 23 males (44.2%) and 29 females (55.8%). The highest incidence of scleroma was identified in individuals from poor, rural areas in the third to fourth decades of life. The nose was affected in all cases. Other affected sites included the nasopharynx, soft and hard palate, larynx and trachea, lacrimal passages, skin, and gingiva. Some patients had atypical presentations. Complete follow-up of all patients was hindered by non-compliance with clinic visits and the long duration of medical treatment. Recurrence or relapse of the granulomatous lesions after initial improvement occurred in 11 patients (21.2%) within 1 to 3 years. Scleroma is a stubborn, chronic, granulomatous bacterial disease. The diverse presentations may mimic neoplasms and other granulomatous conditions. We present cases with unusual presentations and demonstrate the transmission electron microscopic features of these lesions. Furthermore, we confirm the importance of achieving full eradication of the etiologic bacilli to prevent recurrent disease.
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Affiliation(s)
- Samy Elwany
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt.
| | - Hesham Abdel Fattah
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt
| | - Zeyad Mandour
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt
| | - Ahmed Soliman Ismail
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt
| | - Mostafa Abdelnabi
- Department of Otolaryngology, Alexandria University, 4 Kafr Abdou Street #605, Alexandria, 21529, Egypt
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Rhinoscleroma: a case series report and review of the literature. Eur Arch Otorhinolaryngol 2013; 271:1851-6. [DOI: 10.1007/s00405-013-2649-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 07/23/2013] [Indexed: 11/26/2022]
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Role of MR imaging in laryngoscleroma. Eur Arch Otorhinolaryngol 2012; 270:985-8. [DOI: 10.1007/s00405-012-2247-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 10/23/2012] [Indexed: 11/25/2022]
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Rhinoscleroma with involvement of the maxillary sinus, orbital floor, and temporomandibular joint: a case report. J Oral Maxillofac Surg 2011; 70:135-40. [PMID: 21549476 DOI: 10.1016/j.joms.2011.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Revised: 02/01/2011] [Accepted: 02/01/2011] [Indexed: 11/23/2022]
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Fusconi M, Gallo A, De Virgilio A, Natalizi S, Greco A, Zambetti G, de Vincentiis M. B Lymphocyte Subsets in Patients with Rhinoscleroma. Otolaryngol Head Neck Surg 2011; 144:809-14. [DOI: 10.1177/0194599810396134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. To identify the presence of B lymphocytes in the rhinoscleroma granulomas as a possible precursor of plasma cells, whose presence has always been described but whose role is still unclear. Study Design. Case series with chart review. Setting. Sapienza University of Rome. Methods. The study was carried out on 6 patients (3 women, 3 men). The following parameters were examined for each patient: clinical manifestations, number of leukocytes, lymphocytes and lymphocyte subsets (CD3+, CD4+, CD8+, and CD19+) in blood samples, time from the onset of symptoms, biopsies, and expression of CD3, CD4, CD8, and CD20 antigens in tissue samples with immunohistochemical techniques. Results. In this study, the values of CD3+, CD4+, and CD8+ T lymphocyte subsets in venous peripheral blood are in line with previously reported data, whereas CD19+ lymphocyte cells tended to show an ambiguous behavioral pattern. In tissue samples, approximately one-third of the T lymphocyte population showed a CD3+/CD8+ immunophenotype (cytotoxic/suppressor), and two-thirds of the T lymphocytes expressed a CD3+/CD4+ immunophenotype (helper/inducer). The authors also identified an unexpected large amount of CD20+ non-plasmacellular B cells in addition to the plasma cells usually detected in rhinoscleroma biopsies. Conclusions. This study demonstrates the presence of B lymphocytes in rhinoscleroma tissue. It is presumable that the mature B cells activated by antigenic stimulation of Klebsiella rhinoscleromatis are the precursors of the plasma cells typically found in the granuloma of rhinoscleroma.
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Affiliation(s)
- Massimo Fusconi
- Department of Otorhinolaryngology, Audiology, and Phoniatrics “Giorgio Ferreri,” Sapienza University of Rome, Rome, Italy
| | - Andrea Gallo
- Department of Otorhinolaryngology, Audiology, and Phoniatrics “Giorgio Ferreri,” Sapienza University of Rome, Rome, Italy
| | - Armando De Virgilio
- Department of Otorhinolaryngology, Audiology, and Phoniatrics “Giorgio Ferreri,” Sapienza University of Rome, Rome, Italy
| | - Stefania Natalizi
- Department of Experimental Pathology, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Otorhinolaryngology, Audiology, and Phoniatrics “Giorgio Ferreri,” Sapienza University of Rome, Rome, Italy
| | - Giampietro Zambetti
- Department of Otorhinolaryngology, Audiology, and Phoniatrics “Giorgio Ferreri,” Sapienza University of Rome, Rome, Italy
| | - Marco de Vincentiis
- Department of Otorhinolaryngology, Audiology, and Phoniatrics “Giorgio Ferreri,” Sapienza University of Rome, Rome, Italy
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Razek AAKA, Castillo M. Imaging appearance of granulomatous lesions of head and neck. Eur J Radiol 2009; 76:52-60. [PMID: 19501997 DOI: 10.1016/j.ejrad.2009.05.021] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Revised: 05/12/2009] [Accepted: 05/13/2009] [Indexed: 11/29/2022]
Abstract
We aim to review the imaging appearance of granulomatous lesions of the head and neck. Granulomatous lesions are seen in different regions of the head and neck and a difficult diagnostic challenge for the radiologist. Infective granulomas may be due to bacterial or fungal agents. Non-infective granulomas are Wegener's granulomatosis, sarcoidosis, amyloidosis, chemical granuloma and reparative giant cell granuloma. Familiarity with the clinical presentation and imaging features of these lesions can suggest diagnosis in some cases. CT and MR imaging demonstrate the exact location, extension and effect on surrounding structures. A thorough knowledge of age, gender, common location, clinical features and imaging appearance of granulomatous lesions are important for diagnosis.
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Ramachandran P, Piquette C, Poole JA. Rhinoscleroma in a young adult with chronic rhinitis and dyspnea. Ann Allergy Asthma Immunol 2008; 101:335-6. [PMID: 18816882 DOI: 10.1016/s1081-1206(10)60502-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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DeBlasio D, Hansen K, Waibel KH. Periorbital swelling and nasal congestion in a 31-year-old man. Ann Allergy Asthma Immunol 2006; 96:489-93. [PMID: 16597086 DOI: 10.1016/s1081-1206(10)60919-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- David DeBlasio
- Allergy and Immunology Service, Department of Medicine, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650, USA
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De Champs C, Vellin JF, Diancourt L, Brisse S, Kemeny JL, Gilain L, Mom T. Laryngeal scleroma associated with Klebsiella pneumoniae subsp. ozaenae. J Clin Microbiol 2005; 43:5811-3. [PMID: 16272528 PMCID: PMC1287788 DOI: 10.1128/jcm.43.11.5811-5813.2005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Klebsiella pneumoniae subsp. ozaenae was isolated from the pharynx of a woman with laryngeal scleroma. K. pneumoniae subsp. ozaenae is rarely isolated from clinical infections and has never been reported in laryngeal scleroma, which is usually caused by K. pneumoniae subsp. rhinoscleromatis.
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Affiliation(s)
- C De Champs
- Service de Bactériologie-Virologie-Hygiène, CHU Robert Debré Rue du Général Koenig, 51092 Reims Cedex, France.
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Fragoulis KN, Klouvas GD, Falagas ME. Impetigo-like vegetating nasal lesions caused by Klebsiella pneumoniae. Am J Med 2005; 118:925-7. [PMID: 16084190 DOI: 10.1016/j.amjmed.2005.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2005] [Accepted: 03/18/2005] [Indexed: 10/25/2022]
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Abstract
Rhinoscleroma is a chronic, granulomatous infectious disease that responds poorly to treatment. In recent years an increasing number of cases have been reported in nonendemic areas, explained largely by major migratory movements. We describe rhinoscleroma in three siblings. They had ulcerated but painless lesions, which bled spontaneously, and hemorrhagic scabs or crusts in their noses. In one child, the lesions had destroyed the entire left nasal ala and alar cartilage and most of the right. Dermatopathologic study identified the Mikulicz macrophages that contained organisms. It is possible that disposing factors could have been the neutropenia common to the three children and their poor living conditions. They were treated with a combination of trimethoprim-sulfamethoxazole and cefalexin, for a period of 3 months. We present this unusual case history of three siblings affected by a process that is relatively infrequent in our area of practice and is not considered very contagious. It is important to recognize the clinical signs characteristic of this disease, the diagnosis of which is not easy. Improvements in living conditions, hygiene, and health standards are essential prerequisites for its control and prevention.
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