Managing of Rhinoscleroma in Children: Medical vs. Surgical Treatment - What is the Optimal Approach? - A Case Report -

Abstract

Introduction: Rhinoscleroma is a chronic infection caused by Klebsiella rhinoscleromatis, rare in Morocco but endemic in parts of Africa and the Americas. It is linked to poor hygiene, immunodepression, and contact with infected individuals. The disease affects the upper respiratory tract, spreading through inhalation of contaminated droplets and can cause significant nasal and respiratory obstruction.

Case presentation:

A 10-year-old male presented with a 4-years history of nasal obstruction and purulent rhinorrhea. Clinical examination revealed a mass in the right nasal cavity, causing septal deviation and complete obstruction. CT and MRI confirmed the mass, extending to both sides without bone destruction. A biopsy was performed and revealed rhinoscleroma. The patient underwent surgical excision. The histopathological analysis confirmed the diagnosis. The clinical evolution was favorable, with complete resolution of the mass and relief of nasal obstruction, all without long term antibiotic treatment. No recurrence was observed during follow-up.

Conclusion : the main takeaways are that surgery alone was sufficient, with no need for postoperative long term antibiotic therapy , contrary to the literature. The patient had full recovery with no recurrence. Surgery is a viable alternative to long-term medical treatment, especially in children or when antibiotics are contraindicated.