Endoscopy and computed tomography [CT] in lower respiratory tract scleroma

Out of fifty two patients with scleroma, twenty patients with laryngotracheal scleroma [38.5%] were examined by CT and endoscopy. Tracheal involvement was found in 65% [13/20] of cases, whereas bronchial affection was found in 15% [3/20] of cases with laryngeal scleroma and in 23.1% [3/31] of cases with tracheal scleroma. Two patients were presented with supraglottic scleroma. The first one showed supraglotric granulomata, and the second one showed bilateral lateral saccular cysts. Culture of the cyst contents showed klebsiella rhinoscleromatis. Endoscopy was very efficient in diagnosis, staging, and management of these patients. Although diagnosis could not be made on the basis of CT only, CT was useful in determining the extent of the disease as well as the response to therapy

Flexible endoscopy and radiologic evaluation of the eustachian tube in adults with eustachian tube dysfunction

This study was conducted on 20 adult patients presenting with Eustachian tube dysfunction of about six months duration. It included endoscopy of the pharyngeal end of the Eustachian tube together with contrast radiological study. Both methods are now available because of technical progress and practical improvements. By these methods physiological movements of soft palate, tubal torus and the tubal orifice can be observed and studied, anatomical variations and pathological abnormalities can be detected. The present study showed that Eustachian tube dysfunction may be caused by salpingintis [acute or chronic], adenoid, nasopharyngeal carcinoma. Scleroma affecting lumen of Eustachian tube was reported in one case

Nature of antibiotic resistance among clinical isolates of klebsiella rhinoscleromatis

Rhinoscleroma is a chronic granuloma of the upper respiratory tract occurring most commonly in the nose. The main problems associated with this disease are the etiological agent and the difficulty of treatment. Antibiotic resistance of the different K. r. strains and the role of plasmid in mediating resistance and production of B-lactamases were studied in this work. Twenty patients diagnosed clinically and histopathologically as having rhinoscleroma, had not been treated with antibiotics for the last year were selected. Nasal biopsises were taken, inoculated and pure colonies were identified and subjected to full bacteriological studies. Antibiotic sensitivity test was performed on the isolated strains using Bayer-Kirby method. Plasmid screening, preparation of intracellular B-lactamase, and analytical iso-electric focusing were performed. Results were discussed

study of the mycotic flora in the nose of rhinoscleromatous Egyptian cases

This work was an attempt to study the presence of fungi in the nose of rhinoscleromatis patients. Nasal swabs and scrappings were taken from 30 cases of rhinoscleroma and from 30 persons free from any nasal lesion. There was a high incidence of fungal infection in the nose of rhinoscleromatic patients [50%] and only in two cases of the controls [6.6%]. The fungi detected were of the opportunistic type, as they were mostly the Penicillium sp., Fusarium sp. and Aspergillus sp. It was concluded that the fungus in the nose of rhinoscleromatosus patients has no role in the pathogenesis of the disease, as no deeply seated fungal infection was detected in the rhinoscleromatosus lesions and it was not present in every case. So, the nasal condition of rhinoscleroma being warm and obstructed together with the intake of antibiotics, creates a suitable environment for fungal growth and proliferation