granulomatous disease of thee nose Flashcards
what is a granuloma ?
chronic inflammation
microscopically a bunch of epitheliod cells in the centre surrounded by lymphocytes
epitheliod cells may eventually fuse and form giant cells
what are the causes of granulomatous diseases of the nose ?
neoplastic
infectious
immunological
idiopathic
fungal
what are the immunological causes of granulomatous diseases of the nose ?
Lupus
Behcet disease
what are the idiopathic causes of granulomatous diseases of thee nose ?
sarcoidosis
what is the causative organism of rhinoscleroma ?
klebeseilla rhinoscleromatis
what are the stages of rhinoscleroma ?
catarrhal stage
granulomatous stage
cicatricial stage
what are thee featurees of thee catarrhal stage of rhinoscleroma ?
purulent rhinorrhea
nasal honeycombed crusting
what are the features of the granulomatous stage of rhinoscleroma ?
granulomatous nodules usually appear at the mucocutaneous junction
subdermal infiltration of lower part external nose and upper lip
what are the features of the cicatricial stage ?
dense fibrotic reactions that may eventually stenose the nose and the larynx along with the tracheobronchial tree
what are the investigations for cases of rhinoscleroma ?
biopsy
what are the pathogonomic findings in a biopsy taken from a rhinoscleroma patient ?
mikulicz cells and Russell bodies
infiltration of lymphocytes, plasma cells and lymphocytes
what do mikulicz cells look like under the microscope ?
large nucleated foam cells with a vacuolated cytoplasm that contain the causative bacilli
what are Russel bodies ?
homogenous eosinophilic inclusion bodies that reside inside plasma cells as a consequence of plasma cell over stimulation
what is the treatment for Rhinoscleroma ?
long term therapy with either streptomycin or tetracyclin
surgical:
dilatation may be needed for stenosis formed in cicatricial stages
what iis the causative organism in leprosy ?
mycobacteerium leprae
what is the presentatioin of leprosy ?
hypopigmentetd macules, tuberculoid skin
mucosal nodules in the mouth and the nose that subsequently ulcerate
lymphadenopathy
nasal septal perforation
fish mouth deformity
loss of eyebrows
what is the treatment for leprosy ?
dapsone
what is the causative organism in tuberculosis ?
mycobacteriium tubrculosis
what is th presentation of tuberculosis ?
secondary to lung tuberculosis
first nodular infiltration of anterior septum
ulceration and perforation
what is the treatment for tuberculosis ?
anti TB drugs
Rifampicin
isoniazid
pyrazidine
ethambutol
what is thee causative organism in syphillus ?
treeponaeum pallidum
what is the clinical presentation of primary syphillus ?
chancre in oral mucosa
what is thee preesentation of secondary syphillus ?
rhinitis with crusting and fissuring in nasal vestibule
what is thee presentation of tertiary syphillus ?
granulomatous involvement of the oral and nasal mucosa, bony nasal septum perforation
neurosyphillus
what is the investigation for cases of syphillus ?
FTA-ABS
what is the treatment for syphillus ?
penicillin
which of the iinfectious causes of granulomatous diseases of the nose cause septal perforation ?
syphillus
TB
Leprosy
what is thee other name for leprosy ?
hansen’s disease
which of the infectious causes of granulomatous diseases of the nose cause septal perforation ?
syphillus
TB
Leprosy
what type of nasal septal perforation is sen in tertiary syphillus ?
bony septal perforation
( posterior perforation )
