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Laryngotracheobronchial Involvement in a Patient With Nonendemic Rhinoscleroma*

Mordechai Yigla, MD; Ofer Ben-Izhak, MD; Ilana Oren, MD; Nehama Hashman, MSC; Flavio Lejbkowicz, MD
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*From the Division of Pulmonary Medicine (Dr. Yigla), the Department of Pathology (Dr. Ben-Izhak), the Infectious Diseases Unit (Dr. Oren), and the Microbiology Laboratory (Drs. Hashman and Lejbkowicz), Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Correspondence to: Mordechai Yigla, MD, Division of Pulmonary Medicine, Rambam Medical Center, PO Box 9602, Haifa 31096, Israel; e-mail: m_yigla@rambam.health.gov.il



Chest. 2000;117(6):1795-1798. doi:10.1378/chest.117.6.1795
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We report the first case of rhinoscleroma in an Israeli citizen, a former sailor with a transatlantic shipping company. Characteristic histologic changes from a tracheal biopsy and isolation of Klebsiella rhinoscleromatis from a blood culture after diagnostic bronchoscopy confirmed the diagnosis. Extreme delay in the diagnosis, a not uncommon feature in nonendemic areas, was associated with severe advanced laryngotracheobronchial disease. Treatment with quinolones was followed by significant improvement, but the patient died 1 month after presentation, apparently from upper airway obstruction.

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