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Contributors: Edith Lederman MD, Noah Craft MD, PhD
Other Resources UpToDate PubMed


Rhinoscleroma, or Slavic leprosy, is a chronic granulomatous infection of the nasal mucosa, the oropharynx, and upper airways caused by Klebsiella pneumoniae ssp. rhinoscleromatis. There are endemic foci in central Europe, Africa, South America, and Central America. It is typically seen in patients from economically challenged and rural areas.

The disease is characterized by three stages: rhinitic, infiltrative, and nodular stages. The rhinitic or catarrhal stage is characterized by rhinorrhea and nasal obstruction. The discharge is typically fetid and purulent. The infiltrative or granulomatous stage is characterized by granulomatous papules and nodules in the nose and oropharynx. The nodular stage is characterized by deformity of the nose, with both fibrous and sclerotic lesions prevailing. The later aspects of this stage are sometimes referred to as a sclerotic or fibrotic stage. The entire process occurs over months to years. Usually, systemic symptoms are not seen, but chronic headache may be associated. Some evidence of intrafamilial transmission has been reported in close living quarters.


A48.8 – Other specified bacterial diseases

72409005 – Rhinoscleroma

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Differential Diagnosis & Pitfalls

  • Mucocutaneous leishmaniasis
  • Paracoccidioidomycosis
  • Rhinosporidiosis
  • Tertiary syphilis
  • Cutaneous tuberculosis
  • Leprosy
  • Yaws (gangosa and goundou)
  • Extranodal NK/T-cell lymphoma, nasal type
  • Lymphoma
  • Angiosarcoma of skin
  • Nasal polyp

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Last Updated:10/01/2017
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A medical illustration showing key findings of Rhinoscleroma (Rhinitic Stage) : Nasal obstruction, Nose, Rhinorrhea, Hyposmia, Purulent nasal discharge
Clinical image of Rhinoscleroma - imageId=232127. Click to open in gallery.  caption: 'Confluent reddish papules forming a plaque at the inferior nostril.'
Confluent reddish papules forming a plaque at the inferior nostril.
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