Two cases of scleroma in Iran

Scleroma (rhinoscleroma) in a Nigerian maxillo-facial practice. Review and case reports

Scleroma (rhinoscleroma), a chronic granulomatous disease of the upper respiratory tract, is endemic within a confined distribution of geographic foci. Sporadic cases and those arising in poorly defined foci may be unexpected and difficult to diagnose. Three cases from a maxillo-facial unit in northern Nigeria are described, of which two simulated intranasal neoplasms and the third had atypical clinical features. These cases form the first substantial description of scleroma in Nigeria, a country that is part of an indefinite focus of the disease. The epidemiology, clinical features, pathology and diagnosis of scleroma are reviewed.

[Electron microscopical investigation of rhinoscleroma (author's transl)]

A boy from Togo with a resistent Rhinoscleroma was observed. The specific granuloma was examinated by histological and electron microscopic methods. The plasma cells form fibrillary material or guttate Russel bodies in the rough endoplasmatic reticulum. The morphology of Mikulicz-cells and Klebsiella rhinoscleromatis is described. The cells are supposed to be (histiocytic) macrophages. The surface of the germs is coated with a fimbria-like radiate substance which in the vacuoles of the cells is crosslinked. This material could be the eliciting antigen for the formation of Russel bodies. These bodies then may represent immune substances bound within the cell.