Rhinoscleroma

A 63-year-old man presented with a 10-year history of a mass growing in the central region of his face, involving his nose and upper lip. Histopathological examination revealed foamy macrophages, and culture of tissue fragments showed the presence of klebsiella. A 63-year-old man presented with a 10-year history of a mass growing in the central region of his face, involving his nose and upper lip. He had lived his entire life in an isolated tropical region of Mexico and had received no previous treatment for this condition. Physical examination revealed a systemically well man with bilateral nostril obliteration, palate infiltration, and loss of upper teeth (Panel A). Histopathological examination revealed foamy macrophages (Mikulicz’s cells; Panel B, yellow arrow; hematoxylin and eosin) with intracytoplasmic bacilli plasma cells with Russell bodies (green arrow). Culture of tissue fragments showed the presence of klebsiella. . . .